Abstract
Background: The present study aims to compare the results of EASI followed by oral misoprostol and oral misoprostol alone for induction of labour in pregnancies of more than 28 weeks with intrauterine foetal death.
 Methods: The present observational and prospective study is an attempt to compare the efficacy of extra-amniotic saline instillation with Foley catheter prior to oral misoprostol and oral misoprostol alone in induction of labour of pregnancies more than 28 weeks with intrauterine fetal death.
 Results: Most of the cases delivered vaginally in both study groups. The mean induction delivery time in group I was higher than group II and the results were statistically significant on comparing both groups. In group I, 78% cases were delivered within 24 hours whereas in group II 96% cases delivered within 24 hours of induction. There was no significant difference in the mean number of required misoprostol in both groups (p>0.05). Need of supplementation with oxytocin was more in group I as compared to group II and the p value is significant (p<0.01). Mean birth weight in group I was 2.25±0.75 kg and in group II was 2.27±0.77 kg. Maximum number of babies had birth weight between 1.52-2.50 kg with 44% in group I and 40% in group II (p>0.05). Only 4 cases had uterine tachysystole and only 1case had postpartum pyrexia. Very few complications were recorded in both the study groups (p>0.05).
 Conclusion: We concluded that oral misoprostol tablet alone is more effective at inducing and setting up the active labour in pregnancies of >28 weeks with intrauterine foetal death than EASI followed by oral misoprostol. It is inexpensive, has a long shelf life, can be easily stored at room temperature and patient remains ambulatory after induction with oral misoprostol. Oral misoprostol alone seems to have an edge over extra-amniotic saline instillation followed by oral misoprostol in all aspects.
 Keywords: Misoprostol, Extra-amniotic saline, Induction of labour.
Highlights
Induction of labour assigns the course of artificial cervical ripening and initiating uterine contractions followed by active labour with the aim of completing a vaginal delivery[1]There are different methods of inducing labour which includes both pharmacological medication and mechanical or physical method
Background: The present study aims to compare the results of extra-amniotic saline infusion (EASI) followed by oral misoprostol and oral misoprostol alone for induction of labour in pregnancies of more than 28 weeks with intrauterine foetal death
The present observational and prospective study is an attempt to compare the efficacy of extra-amniotic saline instillation with Foley catheter prior to oral misoprostol and oral misoprostol alone in induction of labour of pregnancies more than 28 weeks with intrauterine fetal death
Summary
There are different methods of inducing labour which includes both pharmacological medication and mechanical or physical method. In extra-amniotic saline infusion (EASI) method saline is infused via Foley catheter that is placed through internal cervical os, into the space between internal os and placental membranes. It acts probably by dual mechanism of action through local release of endogenous prostaglandins and mechanical dilatation of cervix[2]. Misoprostol is a synthetic prostaglandin E1 (PGE1) , It has been used for induction of labour and may be administered orally, vaginally or sublingually. It increases the vaginal delivery rate within 24 hours[4]. The present study aims to compare the results of EASI followed by oral misoprostol and oral misoprostol alone for induction of labour in pregnancies of more than 28 weeks with intrauterine foetal death
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