Clarifying the role of misoprostol in obstetrics.

African Health Sciences Editorial
Andrew W eeks
Visiting Lecturer in Obstetrics, Department of Obstetrics and Gynaecology , Makerere University , Kampala, Uganda

When Searle announced in 1988 that they were launching an orally active prostaglandin E1 analogue for the treatment of peptic ulcers, a ripple of excitement went through the African obstetrics community . Oxytocics are crucial drugs in obstetrics, used for treating abortions, inducting of labour and, perhaps most importantly , controlling postpartum haemorrhage. Despite the importance of oxytocics, the currently available preparations are very unsatisfactory .

Ergometrine and oxytocin require a cold chainnand can only be given by injection, whilst the current prostaglandins are unstable and very expensive. But misoprostol is a stable, inexpensive, orally active prostaglandin to which the uterus is very sensitive. The potential of misoprostol seemed immense, especially in the developing world where product stability , cost, and ease of use is crucial.