Vol. 5, Issue 12 (2019)
A comparative study between misoprostol and combination of mifepristone and misoprostol for termination of pregnancy with late intrauterine fetal death
Author(s): Meda Ram, Rizwana Shaheen, Poonam Parakh
Abstract: Background: The antepartum death occurring beyond 28 weeks is termed as intrauterine death. In 80% of women with IUD, spontaneous expulsion occurs by 3 weeks.Oral misoprostol administration for labor induction with IUD was first used in 1987 for obstetrical purposes. Mifepristone administered before Misoprostol sensitizes the uterus to the action of prostaglandins and ripens the cervix. Aims and Objective:To compare the combination of mifepristone and misoprostol regimen with misoprostol only for induction of labor in late intrauterine fetal death. Material and Methods: This was a retrospective observational study included 116 women with IUD after 24 weeks of gestation. They were divided into two groups of 58 each. Group 1 women received 10 µg of misoprostol inserted in posterior fornix every four hour. Subsequently, group 2 women received a single dose of 200 mg mifepristone orally, following which a 24-hour-interval was recommended before administration of misoprostol. After 24 hour, 100µg of misoprostol was inserted into the posterior vaginal fornix. Results: Mean parity was 2 and 2.5 for combination and misoprostol only group respectively and the mean period of gestation was 34 weeks 2 days for combination group and 35 weeks 2 days for misoprostol only group. Mean induction delivery interval in combination group was 8 hours 30 minutes while for misoprostol only it was 14 hours. The mean repeating of 100 micrograms misoprostol in combined group was 1.74 time and 3.6 times in misoprostol only group. Conclusion:Combination therapy of mifepristone and misoprostol is more effective regimen to cut short the labor pain than conventional regimen of misoprostol alone for induction of labor in women with intrauterine fetal death.
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