For medical abortion in the first trimester (up to 63 days/9 weeks), the WHO-recommended regimen is mifepristone followed by misoprostol after how many hours, and by which route?
- A Mifepristone 600 mg orally, then misoprostol 400 mcg sublingual after 48 hours
- B Mifepristone 200 mg orally, then misoprostol 200 mcg orally after 12 hours
- C Mifepristone 200 mg orally, then misoprostol 800 mcg sublingual, buccal, or vaginal after 24–48 hours ✓
- D Methotrexate 50 mg/m² IM, then misoprostol 800 mcg vaginal after 7 days
Correct answer: C. Mifepristone 200 mg orally, then misoprostol 800 mcg sublingual, buccal, or vaginal after 24–48 hours
Explanation
The current WHO-recommended regimen for medical abortion up to 9 weeks is mifepristone 200 mg orally followed 24–48 hours later by misoprostol 800 mcg administered sublingually, buccally, or vaginally. The 200 mg mifepristone dose is as effective as the older 600 mg dose with fewer side effects. Sublingual route has highest bioavailability but more GI side effects; vaginal route has better tolerability. Success rate exceeds 95% at up to 63 days.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
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Written and medically reviewed by the StethoPrep medical team.