Gemeprost vaginal pessaries for inducing third-trimester intrauterine deaths.

Abstract

In 3rd trimester fetal death, when the cervix requires softening, labor may be induced by the administration of intravenous, intra-or extraamniotic, or vaginal prostaglandin E2 or intramuscular injections of synthetic prostaglandins, such as 15(S)-methyl prostaglandin F2 alpha. These methods all have various disadvantages. In 10 women with 3rd trimester intrauterine death, labor was induced by vaginal insertion of a 1 mg gemeprost (16,16-dimethyl-trans delta 2 prostaglandin E1 methyl ester) pessary. The mean number of pessaries s required was 1.9, and the mean duration of labor was 11.7 hours. The women remained mobile during most of the procedure. No patient required additional oxytocin, and the only side effects were mild fever and diarrhea.