title: [Fetal death beyond 14 weeks of gestation: induction of labor and obtaining of uterine vacuity].
abstract: The objective of this review was to assess benefits and harms of different management options for induction of labor and obtaining of uterine vacuity in case of fetal death beyond of 14 weeks of gestation. In second-trimester, the data are numerous but low methodological quality. In terms of efficiency (induction-expulsion time and uterine evacuation within 24 hours rate) and tolerance in the absence of antecedent of caesarean section, the best protocol for induction of labor in the second-trimester of pregnancy appears to be mifepristone 200mg orally followed 24-48 hours later by vaginal administration of misoprostol 200 to 400 μg every 4 to 6 hours. In third-trimester, there is very little data. The circumstances are similar to induction of labor with living fetus. A term or near term, oxytocin and dinoprostone have a marketing authorization in this indication but misoprostol may be an alternative as the Bishop score and dose of induction of labor with living fetus. In case of previous caesarean section, the risk of uterine rupture is increased in case of a medical induction of labor with prostaglandins. The lowest effective doses should be used (100 to 200 μg every 4 to 6 hours). Prior cervical preparation by the administration of mifepristone and possibly the use of laminar seems essential in this situation.
authors.affiliation: Service de gynécologie obstétrique et médecine de la reproduction, CHU de Caen, avenue Côte-de-Nacre, 14033 Caen cedex 9, France. Electronic address: beucher-g@chu-caen.fr.
authors.forename: G
authors.initials: G
authors.lastname: Beucher
authors.affiliation: Service de gynécologie obstétrique et médecine de la reproduction, CHU de Caen, avenue Côte-de-Nacre, 14033 Caen cedex 9, France.
authors.forename: P
authors.initials: P
authors.lastname: Dolley
authors.affiliation: Service de gynécologie obstétrique et médecine de la reproduction, CHU de Caen, avenue Côte-de-Nacre, 14033 Caen cedex 9, France; UFR de médecine, université de Caen Basse Normandie, avenue Côte-de-Nacre, 14033 Caen cedex 9, France.
authors.forename: Z
authors.initials: Z
authors.lastname: Stewart
authors.affiliation: Service de gynécologie obstétrique, centre hospitalier de l'Ouest Guyanais, 16, avenue du Général-de-Gaulle, BP 245, 97393 Saint-Laurent-du-Maroni cedex, Guyane française.
authors.forename: G
authors.initials: G
authors.lastname: Carles
authors.affiliation: Service de gynécologie obstétrique, pôle Femme-Mère-Enfant, groupe hospitalier du Havre, BP 24, 76083 Le Havre cedex, France.
authors.forename: E
authors.initials: E
authors.lastname: Grossetti
authors.affiliation: Service de gynécologie obstétrique et médecine de la reproduction, CHU de Caen, avenue Côte-de-Nacre, 14033 Caen cedex 9, France; UFR de médecine, université de Caen Basse Normandie, avenue Côte-de-Nacre, 14033 Caen cedex 9, France.
authors.forename: M
authors.initials: M
authors.lastname: Dreyfus
mesh_terms: D005260:Female; D005313:Fetal Death; D006801:Humans; D007751:Labor, Induced; D016595:Misoprostol / Q000008:administration & dosage; D010120:Oxytocics / Q000008:administration & dosage; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011263:Pregnancy Trimester, Third
chemical_list: D010120:Oxytocics; D016595:Misoprostol
keywords: Déclenchement; Induction du travail; Labor induction; Late intrauterine fetal death; Misoprostol; Mort fœtale; Pregnancy loss; Pregnancy termination; Stillbirth