[Use of misoprostol in gynecology and obstetrics]

Although misoprostol is a widely used medication in gynecology and obstetrics, it is an off label drug that is not officially approved and used in an illegal way. This literature review shows its efficacy and safety in most of its indications in gynecology and obstetrics. Misoprostol is effective in cervical priming before curettage or operative hysteroscopy. Medical abortion using a combination of mifepristone followed 36 to 48 h by misoprostol seems efficient. The induction of abortion after 17 weeks gestation can be achieved also by using misoprostol. The cervical ripening and induction at term by misoprostol cannot be a first line therapy because of its sides effects on uterine contractility and fetal heart rate. After failure of other methods, it could be proposed. The use of misoprostol in prevention and management of postpartal hemorrhage seems efficient but more studies are needed particularly randomised contre sulfoprostone.