As ladies, we know pregnancy happens. And, sometimes pregnancies don’t go as planned.
Labor can be difficult. Postpartum bleeding can happen: postpartum hemorrhage (PPH) is the number one cause of maternal mortality in many African countries. Also, we can lose the baby through a miscarriage or spontaneous abortion. Or, we may terminate the pregnancy – have an abortion – for many reasons.
Many things can happen when you’re pregnant. But, medical advances – especially affordable ones that can be used in low-income settings – haven’t been common.
Enter misoprostol. Misoprostol was developed in the 1980’s as a stomach ulcer drug and was not prescribed for pregnant women because it could cause miscarriage. As medical providers began to understand the effect misoprostol had on the cervix and uterus, they began to use it “off label” to induce labor, medically manage miscarriages and for medical abortion.
Many African countries are leading the way in registering misprostol officially for obygn and reproductive health uses. The drug can be administered orally, under the tongue, vaginally or in the rectum. Smaller doses are used for “cervical ripening” to induce labor or prepare for uterine surgical procedures. Larger doses are used for the medical management of miscarriage and abortion with or without mifepristone.The big news is that the East African Community (EAC), including Tanzania, Uganda and Rwanda, just approved Indian drug maker Cipla’s misprostol. A press release on the topic came out in June. Cipla registered two dosages under the brand names Misoprost 200 and Pill 72.
For more information about misoprostol and its various obgyn usages, see a review on the journal Obstetrics and Gynecology and the Gynuity website.