Publication:

Misoprostol: history and clinical aspects

Misoprostol, a synthetic prostaglandin E1 analog, was originally developed for NSAID-induced gastric ulcers and is now widely used in obstetric and gynaecologic procedures. It acts as a prodrug, rapidly converted in the liver to misoprostol acid, which binds EP-3 receptors to induce uterine contractions. Misoprostol is effective for medical abortion, postpartum hemorrhage prevention, labour induction, cervical preparation and reducing blood loss during gynaecologic surgeries. Administration routes include oral, sublingual, buccal, rectal and vaginal, with dosing tailored to indication and gestational age. Adverse effects are generally mild but may include diarrhoea, nausea, fever and rarely, uterine rupture or teratogenic effects. Contraindications include prostaglandin hypersensitivity and advanced pregnancy with prior uterine scars. Overall, misoprostol is a versatile, generally safe drug with significant clinical applications in reproductive health.