A 30-year-old woman has a missed abortion at 10 weeks. Ultrasound confirms no fetal cardiac activity with CRL 26 mm. She opts for medical management. The WHO-recommended regimen for medical management of missed abortion at this gestation is:
- A Misoprostol 400 µg orally every 3 hours for 5 doses
- B Oxytocin 20 units IV infusion alone
- C Mifepristone 200 mg followed 24–48 hours later by misoprostol 800 µg vaginally ✓
- D Dinoprostone cervical gel followed by surgical evacuation
Correct answer: C. Mifepristone 200 mg followed 24–48 hours later by misoprostol 800 µg vaginally
Explanation
The WHO recommended regimen for medical management of missed abortion up to 12 weeks is mifepristone 200 mg orally followed 24–48 hours later by misoprostol 800 µg vaginally, with a reported complete expulsion rate of approximately 90%. Oral misoprostol alone is less effective than vaginal misoprostol combined with antiprogestogen priming. Oxytocin is ineffective for first-trimester evacuations.
Reference: Williams Obstetrics, 26th ed.
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Written and medically reviewed by the StethoPrep medical team.