A 10-week intrauterine pregnancy is to be medically terminated. The most effective combination regimen approved for medical abortion is:
- A Methotrexate 50 mg/m² IM followed by misoprostol 800 µg vaginally at 3–7 days
- B Mifepristone 200 mg orally followed 36–48 hours later by misoprostol 800 µg buccal/vaginal ✓
- C Misoprostol 800 µg vaginally every 3 hours (up to 5 doses)
- D Mifepristone 200 mg orally followed immediately by misoprostol 400 µg sublingual
Correct answer: B. Mifepristone 200 mg orally followed 36–48 hours later by misoprostol 800 µg buccal/vaginal
Explanation
The combination of mifepristone 200 mg orally followed 36–48 hours later by misoprostol 800 µg (buccal or vaginal) is the WHO-endorsed most effective regimen for medical abortion up to 12 weeks with complete abortion rates > 95%. The 36–48 hour interval allows mifepristone to sensitise the uterus to prostaglandins. Immediate administration (option D) reduces efficacy. Methotrexate-misoprostol is a second-line alternative used when mifepristone is unavailable.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.