The use of the drug ‘misoprostol’ is an integral part of both medical and surgical methods of terminating a miscarriage. In UK, misoprostol is a prostaglandin that has been licensed in the treatment of stomach ulcer. As misoprostol causes contractions and bleeding of the womb, it has been used for the purpose of emptying of the womb in the event of a miscarriage. However, miscarriage is not a ‘licensed indication’ of the use of misoprostol.
Nevertheless, doctors routinely prescribe medication for uses other than those indicated on a drug’s licence, based on their clinical judgement and evidence presented in the scientific literature. A recent literature review supports the use of misoprostol as a medical treatment to treat miscarriages. This specific use of misoprostol is also supported by the Royal College of Obstetricians and Gynaecologists in the UK.
It is therefore the policy of the trust to allow the unlicensed use of misoprostol for both surgical and medical treatments of miscarriage, in accordance with its Medicine Policy.