[Adverse effects of misprostol in pregnancy]

Although Misoprostol is an already widely used medication in gynecology and obstetrics, extended studies on dosage and safety are still missing. As far as the application of Misoprostol in gynecology and obstetrics is concerned, we are moving between legality and illegality, because in countries like Switzerland and Germany this drug wasn't officially approved for obstetric-gynecologic indications yet.

The aim of the recent work is to give an overview on the indications of Misoprostol in gynecology and obstetrics, the dosages and side effects. Indications are as follows: 1. induction of abortion in the first and second trimester (maximum up to the 22nd week of gestation) 2. cervical ripening and induction of labour in the third trimester (from 36th week of gestation) 3. prevention and therapy of postpartal hemorrhage.

There is no doubt that Misoprostol is an efficient drug for both the obstetrical management at the end of normal pregnancy and the third stage labour as well as termination of pregnancy and induction of abortion in the first and second trimester of pregnancy. This has been concluded from many randomized trials. The side effects of this drug however, have become more obvious over time, especially uterine rupture and the probably elevated perinatal morbidity secondary to the hyperstimulation syndrome.

The application of Misoprostol for labour induction in an outpatient setting is absolutely contraindicated. As long as not all critical questions are answered conclusively, this beneficial drug should only be applied under hospital conditions with close surveillance.