Mifepristone Followed by Prostaglandin Vs Prostaglandin alone for induction of Labour in Intrauterine Foetal Death at or more than 28 Weeks of Pregnancy.

ABSTRACT

Introduction: Intrauterine fetal death (IUFD) is a rare butdevastating event for the mother and family. Rapid expulsionof the foetus is usually requested, although there are nomedical grounds for it. Labour following IUFD often needsto be induced by medical means. Prostaglandin analogues,such as misoprostol and gemeprost, have been extensivelystudied and proven to be safe and effective in the inductionof abortion in the second trimester of pregnancy. Hence, theaim of the present study was to compare the required dose ofprostaglandin and induction delivery interval in Mifepristonewith Prostaglandin and Prostaglandin alone in IntrauterineFoetal Death at or more than 28 weeks of pregnancyMaterial and methods: The present was a prospective studyin which women came with ultrasonography confirmedintrauterine death were counselled and divided into twogroups randomly. First group had Tab mifepristone (200mg)orally followed by Dinoprostone gel intracervically after 24hrs and misoprostol (50mcg) 4 hourly thereafter, whereassecond group had a multivitamin tablet orally and after 24hours dinoprostone gel applied intracervically followed bymisoprostol tab (50 mcg) 4 hourly upto maximum 6 doses inboth groups.Results: The induction to delivery interval in hours wasfound to be higher in Group B than A. This was found to bestatistically significant at p value 0.021. Number of dosage ofmisoprostol was also seen higher in majority of cases in GroupB which was also found to be statistically significant.Conclusion: This study showed that combination ofMifepristone (200 mg) and prostaglandin was found to bemore effective than Prostaglandin alone for induction oflabour in intrauterine foetal death of 28 weeks or more.