Bibliographic Info
GuidelineMedical management of abortion
Year of Publication2018
Issuing InstitutionWorld Health Organization
Recommendation
Status
Maintained
Recommended in favor
Strong
Certainty of evidence
Moderate
Medical management of induced abortion at < 12 weeks of gestation. We recommend the use of 200 mg mifepristone administered orally, followed 1–2 days later by 800 μg misoprostol administered vaginally, sublingually or buccally. The minimum recommended interval between use of mifepristone and misoprostol is 24 hours
Notes and Remarks
- 1.In this guideline, duration of pregnancy (gestation) is the size of the uterus, estimated in weeks, based on clinical examination, that corresponds to a pregnant uterus of the same gestational age dated by last menstrual period (LMP).
- 2.Combination regimen is recommended because it is more effective.
- 3.Consideration for patient and provider preference suggests the inclusion of all routes, including buccal administration
- 4.There is limited evidence to suggest that simultaneous dosing of mifepristone and misoprostol is efficacious
- 5.This recommendation has been updated from the WHO 2012 Safe abortion guidance. This updated recommendation applies to pregnancies up to 12 weeks of gestation, whereas in the prior guidance, different regimens were recommended for pregnancies up to 7 weeks, 9 weeks and 12 weeks. For the recommended misoprostol-only regimen, buccal route of administration has been added and the maximum number of doses has been removed. Interval dosing has been removed and a note has been added that repeat doses of misoprostol can be considered to achieve success of the abortion process
Also Featured In
This recommendation also appears in the following guidelines:
Guideline
Abortion care guideline
Year2022
InstitutionWHO
Guideline
Abortion care guideline, 2nd ed
Year2024
InstitutionWorld Health Organization