Low Dose Vaginal Misoprostol in the Management of Women with Intrauterine Fetal Death

摘要

Objectives: The study was conducted to assess the effectiveness and side effects of vaginal misoprostol (Vagiprost? tablet) in termination of second and third trimester pregnancy complicated with intrauterine fetal death.Design: A prospective observational cohort study.Setting: Tanta University Hospital.Patients: The study was carried out on 324 women with fetal demise in the second and third trimesters. Cases were collected during the period from January 2008 to December 2009.Intervention: All patients were subjected to history taking, physical examination, Bishop Scoring. Application of 25 μg misoprostol in the posterior fornix of the vagina, this will be repeated every 4 hours over 24 hours. The adverse effects, progress, and outcomes were assessed.Results: the success rate was 90% and 45% in women with third and second trimesters respectively. The mean induction-termination interval was 8.95 ± 2.63 and 15.3 ± 5.37 hours for women with third and second trimesters respectively. The induction termination interval correlated negatively with the duration of gestation. Approximately, 90% of second trimester and 55% of third trimester women required oxytocin augmentation. The mean value of total required dose of misoprostol was 166.3 ± 7.5 and 120 ± 28.79 μg for women with second and third trimesters respectively.Conclusion: Vagiprost appears to be a safe, effective, practical, and inexpensive method for termination of third trimester pregnancy complicated with of intrauterine fetal death (IUFD), its effects increase with parity and duration of gestation.