VAGINAL MISOPROSTOL FOR SECOND AND THIRD TRIMESTER LABOUR INDUCTION IN WOMEN WITH INTRAUTERINE FETAL DEATH

Objectives : To evaluate the effect of repeated vaginal administration of small doses of misoproslol for termination of
pregnancy in cases of second and third trimester pregnancies complicated with intra-ulcrinc fetal death (IUFD).
Design: A prospective Clinical Trial.
Setting : Tanta University Hospitals .
Patients : The study was carried out on 40 women during the second and third trimesters of pregnancy complicated
with IUFD.
Intervention: All the patients were subjected to history taking, physical examination, Bishop Scoring. Application of
25 ug misoprostol (Vagiprost® tablet) in the posterior fornix of the vagina, which will be repeated every 4 hours over
24 hours.
Outcome measures: The primary outcome measure was the success rate, the secondary outcome measure was the
induction to delivery time, and third outcome measure was the number of patients requiring augmentation with
oxytocin and all complications were recorded.
Results: The mean value of induction contraction interval in cases of 2nd trimester IUFD (15.3±5.37 hours) was
significantly higher than that in cases of 3rd trimester IUFD (8.95+2.625 hours). There was a significant negative
correlation between gestalional age and induction contraction interval as well as induction delivery interval. The
success rate was 90% and 45% in the third and second trimesters respectivley. Ninety percent of 2nd trimester cases
and 55% of 3rd trimester cases required oxytocin augmentation. The mean values of total required dose of misoprostol
required for induction wer 120+.28.79 u.g and 166.3±7.5 fig for the third and second trimesters respectively.
Conclusion: Vagiprost is a very effective drug for termination of pregnancy in cases of IUFD, its effects increase in
direct proportion with parity and duration of pregnancy.