title: Misoprostol use under routine conditions for termination of pregnancies with intrauterine fetal death.
abstract: OBJECTIVE
  To analyze the misoprostol use in pregnancies with intrauterine fetal death (IUFD), considering mode of delivery and induction-delivery interval.
  
  
  METHODS
  Descriptive study including 171 pregnant women with IUFD, in the second or third trimester, submitted to labor induction with vaginal misoprostol and/or induction/augmentation with intravenous oxytocin, from 2005 to 2008, at a teaching-hospital of the Brazilian Unified Health System (Sistema Único de Saúde - SUS).
  
  
  RESULTS
  Misoprostol alone (treatment A), misoprostol plus oxytocin (treatment B), and oxytocin alone (treatment C) were administered in 9.3%, 19.9%, and 70.8% of the cases, respectively. One-third of pregnancies were less than 28 weeks, and 2.9% required a caesarean section. The percentage of vaginal delivery in treatments A and B combined (98.0%) was similar to treatment C (96.7%). The mean induction-delivery interval was 15.4hours. Comparing multiple groups, the mean induction-delivery interval was significantly shorter in treatment A (20.1hours) than in treatment B (33.3hours), and was longer than in treatment C (9.7hours). The majority (71%) of cases required a single administration of misoprostol, and the total dosage was lower in treatment A (mean: 98.4μg) compared with treatment B (mean: 157.0μg).
  
  
  CONCLUSIONS
  Misoprostol effectively contributed to delivery of IUFD by vaginal route assisted under routine conditions of a public health service in Brazil, demonstrating its importance in cases resistant to usual induction methods, and its availability in Brazilian public health services is recommended.
authors.affiliation: Hospital Geral de Nova Iguaçu, Nova Iguaçu, RJ, Brazil. ysamaria@uol.com.br
authors.forename: Maria Isabel do
authors.initials: MI
authors.lastname: Nascimento
authors.forename: Alfredo de Almeida
authors.initials: Ade A
authors.lastname: Cunha
authors.forename: Sandra Regina dos Santos Muri
authors.initials: SR
authors.lastname: Oliveira
authors.forename: Glaucimara Gonzaga
authors.initials: GG
authors.lastname: Nunes
authors.forename: Felipe Silva
authors.initials: FS
authors.lastname: Alvarez
authors.forename: Eduardo Loyola
authors.initials: EL
authors.lastname: Villas Bôas
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage*; D000028:Abortion, Induced / Q000379:methods*; D000328:Adult; D004359:Drug Therapy, Combination; D005260:Female; D005313:Fetal Death; D006801:Humans; D016595:Misoprostol / Q000008:administration & dosage*; D010121:Oxytocin / Q000008:administration & dosage*; D011247:Pregnancy; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D016595:Misoprostol; D010121:Oxytocin
keywords: Delivery obstetric; Fetal death; Feto morto; Labor induced; Misoprostol; Ocitocina; Oxytocin; Parto obstétrico; Stillbirth; Trabalho de parto induzido; Óbito fetal