Administration of MS-2 Step (Up to 63 days)

Question 1

What imaging should you do before starting MS-2 Step?

Answer 1

USS to exclude ectopic and confirm pregnancy.

Question 2

What pathology tests should you do?

Answer 2

1/ Rhesus status

2/ STI Screening - Chlamydia and Gonorrhoea.

Question 3

If they are Rh -ve, what should you give?

Answer 3

Rh D immunoglobulins (250 iu) within 72 hours of Mifepristone Linepharma administration.

Question 4

What other medications should you give awith the MS 2-Step?

Answer 4

1/ Prophylactic antibiotics (recommendedd by RCOG)
2/ Pain Relief - NSAIDs & codeine most effective.
3/ An entiemetic can be considered.

Question 5

What are the colours of the packs?

Answer 5

1/ Mifepristone Linepharma - green pack.

2/ GyMiso (Misoprostol) - purple pack.

Question 6

How is MS-2 Step taken?

Answer 6

1/ Start with the green pack. Take the Mifiprestone orally.
2/ Then 36-48 hours later take all 4 GyMiso tablets in the purple pack buccally. Put them between your cheek and gum for 30 minutes. After this, any residue can be swallowed.

Question 7

When does the cramping start?

Answer 7

Within 4 hours of taking misoprostol. (the purple pack) It can be more than normal menstrual cramping.

Question 8

How long can bleeding occur?

Answer 8

10-16 days and it may be heavy.