Misoprostol obstetrical use regulation in Latin America and The Caribbean countries

Objectives: To update information on misoprostol obstetrical use regulations in Latin America and The Caribbean. Methods: A semi structured questionnaire was sent to key Latin America and The Caribbean countries' informants. The informants consulted different sources in each country either public or private sectors. Answers were incorporated in a database in order to obtain the frequency of each variable studied. Results: Eighteen of the 19 countries where the questionnaire was sent answered. In the case of Mexico two formularies were used, for the Federal District and for the rest of the country. All Latin America and The Caribbean countries have regulations to use misoprostol in Obstetrics, usually elaborated by the Ministry of Health. Misoprostol is mainly indicated for labor induction with either live or dead fetus; but most countries use it for prevention and management of post partum hemorrhage, in treatment of incomplete abortion, and in the legal setting of abortion induction. The norm is very well accomplished in the various countries, but it is evident that they control its use, because in ten of them the prescription is retained, in two the medication is institutional only and in one the prescription is retained occasionally. Physician not using the medication according to Norm was mainly because of lack of information, lack of capacitation and fear; conscientious objection and non-access to the medication were present in one third of the countries. Conclusions: Misoprostol is a drug used in all Latin America and The Caribbean countries and its use in Obstetrics is regulated. Professionals are using it regularly according to the Norm established.