ABSTRACT
Surgical termination of pregnancy carries high risk for the women's health. Medical methods including prostaglandins are safe and reduce the above risk. This study was done to assess the efficacy of misoprostol as a medication for the termination of second trimester fetal demise. Design: Observational study. Setting: Department of Obstetrics and Gynecology Unit 2, Civil Hospital, Karachi and Dow Medical College. The study period was from January 2001-December 2001. A total of 50 patients requiring termination of pregnancy for fetal demise between 14 to 20 weeks of gestation were included in the study. Each woman received misoprostol vaginally. The dose was repeated at six hour interval, until adequate contraction or cervical ripening were achieved. Maximum dose given was 800 ug. [4 tablets]. The dose was not repeated after 4 tablets. Outcome measures included successful termination rates, mean expulsion time and side effects of medication. The mean dose of drug required was 200 ug. The average expulsion time was 9.3 hours. Evacuation of uterus was required in 2 patients and in 2 patients procedure failed, requiring other method of termination. The efficacy of the method was as high as 96%. Use of misoprostol in second trimester for fetal demise is recommended. It is not only safe but is effective as well