Following the Government of India and FIGO recommendation, what is the standard dosing schedule for vaginal misoprostol when used for induction of labour at term with an unfavourable cervix and no previous uterine scar?

• A 400 mcg vaginally as a single dose
• B 100 mcg vaginally every 6 hours
• C 50 mcg vaginally every 2 hours
• D 25 mcg vaginally every 4 hours ✓

Explanation

For term induction with an unripe cervix and an unscarred uterus, both FIGO and the Indian Ministry of Health recommend low-dose misoprostol, 25 mcg placed vaginally and repeated every 4 hours. Higher doses of 50 mcg or more are associated with significantly increased rates of tachysystole and hyperstimulation syndrome. The 400 mcg single dose is reserved for medical termination of pregnancy in the second trimester, not term labour induction.

Reference: Ian Donald's Practical Obstetric Problems, 8th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.