For cervical ripening at term using vaginal misoprostol, which dosing regimen is recommended?
- A 100 mcg every 6 hours
- B 25 mcg every 4 to 6 hours ✓
- C 50 mcg every 4 hours
- D 200 mcg as a single dose
Correct answer: B. 25 mcg every 4 to 6 hours
Explanation
ACOG recommends 25 mcg of vaginal misoprostol every 4 to 6 hours for cervical ripening at term. Higher doses such as 50 mcg produce significantly more tachysystole with fetal heart rate changes without improving outcome, and 100 or 200 mcg are unacceptable for this indication. Misoprostol should be avoided altogether in women with a previous cesarean scar. Doses must be reduced or withheld if tachysystole occurs.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.