What is the recommended dose of misoprostol for expulsion after a second-trimester loss?

The recommended dose of misoprostol for expulsion after a second-trimester loss is 800 micrograms administered rectally. This route and dosage have been shown to be effective in inducing uterine contractions and facilitating the expulsion of retained products of conception in this specific clinical context.

When misoprostol is administered rectally, it allows for rapid absorption and a more reliable systemic effect, which is especially important when dealing with the complexities of second-trimester losses. The rectal administration also bypasses potential absorption issues related to gastrointestinal variability that can occur with oral dosing.

Other oral doses, while sometimes used in different contexts or stages of pregnancy, do not match the effectiveness and safety profile established for the rectal route at this dosage in the case of second-trimester loss.