What is a typical dosing option for misoprostol (Cytotec) in postpartum hemorrhage management?

• A. Oral 400 mcg.
• B. Intravenous 1000 mcg.
• C. Rectal 200 mcg.
• D. Rectal dosing of 800–1000 mcg.

Answer: (D)

Misoprostol acts as a uterotonic to promote uterine contractions and control postpartum hemorrhage due to atony. For active management, the typical dosing option is a single rectal dose of 800–1000 micrograms. The rectal route provides reliable absorption and is practical in the immediate postpartum setting, especially when IV access isn’t available or oral intake is compromised. This dose is large enough to produce a meaningful uterotonic effect while remaining a convenient single-dose regimen. Lower oral dosing (such as 400 mcg) is not the standard for treating active PPH, and very small rectal doses (like 200 mcg) won’t reliably achieve the desired effect. Intravenous administration of misoprostol is not a common or recommended route for PPH management.