Misoprostol-only versus mifepristone plus misoprostol in induction of labor following intrauterine fetal death.
BACKGROUND
Both misoprostol-alone and a combination of mifepristone plus misoprostol have been used in induction of labor in cases of intrauterine fetal death (IUFD).


METHODS
Data from 130 women with IUFD at 21-42 weeks of gestation were analysed retrospectively. A total of 82 women received 100 microg (median) of misoprostol at 4-h intervals. Some 48 women received 200 mg of mifepristone, followed 19 h (median) later by single doses of 25 microg of misoprostol at 4-h intervals.


RESULTS
The induction-to-delivery time did not differ between the groups (13.3 versus 12.8 h). However, between 21 and 25 weeks of gestation, the induction-to-delivery time was shorter with the combination regimen (p=0.04). The total dose of misoprostol needed was lower in the group pre-treated with mifepristone (p=0.0028). The 2 groups did not differ as regards complications experienced during labor and delivery.


CONCLUSIONS
Both regimens, misoprostol-only and the combination of mifepristone and misoprostol, are effective and safe in induction of labor after IUFD. Pre-treatment with mifepristone is more effective at earlier gestational weeks.
Väyrynen
Wilma
W
Department of Obstetrics and Gynecology, University of Helsinki, Finland.
Heikinheimo
Oskari
O
Nuutila
Mika
M
D000020:Abortifacient Agents, Nonsteroidal / Q000627:therapeutic use*; D000021:Abortifacient Agents, Steroidal / Q000627:therapeutic use*; D000293:Adolescent; D000328:Adult; D004359:Drug Therapy, Combination; D005260:Female; D005313:Fetal Death; D006801:Humans; D007751:Labor, Induced / Q000379:methods*; D015735:Mifepristone / Q000627:therapeutic use*; D016595:Misoprostol / Q000627:therapeutic use*; D011247:Pregnancy; D012189:Retrospective Studies; D018709:Statistics, Nonparametric
D000020:Abortifacient Agents, Nonsteroidal; D000021:Abortifacient Agents, Steroidal; D016595:Misoprostol; D015735:Mifepristone