For induction of labour at term with an unfavourable cervix, vaginal misoprostol is used. According to ACOG recommendations, what is the appropriate low dose and minimum repeat interval?

• A 10 micrograms repeated every 1 hour
• B 25 micrograms repeated no more often than every 3 to 6 hours ✓
• C 50 micrograms repeated every 12 hours
• D 100 micrograms as a single dose followed by oxytocin after 6 hours

Explanation

ACOG recommends 25 micrograms of vaginal misoprostol for cervical ripening and induction at term, with doses given no more frequently than every 3 to 6 hours because of cumulative effect and risk of tachysystole with uterine rupture. Higher doses such as 50 micrograms increase hyperstimulation rates substantially, and oxytocin should not be started until at least 4 hours after the last misoprostol dose to avoid additive uterotonic effects.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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