Abstract :
Purpose: Late intrauterine death is an unwanted consequence of pregnancy. The estimated global still birth rate is 18.9 per 1000 births. For a physician confronted with IUFD the management poses a dilemma as to which regimen to follow for effective and safe delivery of the dead fetus. This problem is magnified in cases where prostaglandins are contraindicated but the various methods described and followed worldwide incorporate the use of prostaglandins for induction of labour. This study was conducted to show the efficacy and safety of medical management using mifepristone alone for induction of labor.
Methods: We included 60 patients with late IUFD and divided the patients randomly into two groups each containing 30 patients. Group I was given only mifepristone at a dose of 200mg three times a day for two days while Group II was given a combination of mifepristone and misoprostol.
Results: In Group I, 19 patients with previous cesarean were included. The success rate was 90% in group I and 96.6% in Group II. The mean induction to delivery interval was 48.63±25.1 hrs in group I while it was 68.87±21.1 hrs in group II. 3.2% of patients in group I had side effects while 70% of patients in group II had side effects in the form of nausea, vomiting, fever and shivering.
Conclusion: Thus use of mifepristone alone provides a good alterative regimen in the management of late intrauterine fetal death.
Keyword :
Intrauterine fetal death, Mifepristone, Misoprostol, Previous cesarean section