What is the maximum recommended initial dose of a vaginal misoprostol tablet for cervical ripening and induction of labour at term?

• A 200 microgram
• B 100 microgram
• C 50 microgram
• D 25 microgram ✓

Explanation

For term cervical ripening the recommended vaginal misoprostol dose is 25 micrograms, repeated no more often than every 3 to 6 hours, because 50 micrograms and higher carry unacceptably increased rates of tachysystole with associated fetal heart rate abnormalities. The 100 and 200 microgram strengths correspond to the licensed anti-ulcer tablet sizes, and using them obstetrically markedly raises the risk of uterine rupture, especially in parous women and those with a scarred uterus.

Reference: ACOG Practice Bulletin: Induction of Labor, Reaffirmed current practice guidance ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.