Low Dose Vaginal Misoprostol in the Mangement of Intrauterine Fetal Death: Two Years Retrospective Study at Navodaya Medical College, Raichur

Abstract

Introduction: Management of intrauterine fetal death (IUFD) poses dilemma for obstetrician.1 Options for health care are either to await for spontaneous labour or to induce labour.2 Medical consequences of postponing delivery can be significant in view of complications like disseminated intravascular coagulopathy or haemorrhage and even maternal death. Aims and Objectives: To evaluate effectiveness and side effects of repeated vaginal administration of small doses of misoprostol in termination of second and third trimester pregnancies.1 Methods: This study carried out on 100 women with IUFD in second and third trimester pregnancies collected from NMC Medical college, RAICHUR, from October 2017 to October 2019. Patients history taken, physical examination, Bishop scoring assessed. 25µg of misoprostol in the posterior fornix of vagina was placed every 4th hourly over 24 hours. The progress, and outcomes were assessed. Results: The success rate was 92.76% and 64.52% in women with third and second trimesters respectively. The mean induction-delivery interval was 15.67+9.64 and 24.94+8.23. The induction delivery interval correlated negatively with the duration of gestation age. The mean value x of total required dose of misoprostol was 192.42 +128.99 and 361.29 + 139.92 for 2nd trimester and 3rd trimester women. Conclusion: Low dose Misoprostol appears safe, effective, practical and inexpensive method for termination of third trimester pregnancies compared to second trimester pregnancies complicated with Original Research Article Indian Journal of Obstetrics and Gynecology Volume 8 Number 4, October–December 2020 DOI: http://dx.doi.org/10.21088/ijog.2321.1636.8420.7 intrauterine fetal death and its effects increases with duration of gestation.