title: Mifepristone and misoprostol compared with misoprostol alone for induction of labor in intrauterine fetal death: A randomized trial.
abstract: OBJECTIVE
  To assess whether mifepristone and misoprostol are more beneficial than misoprostol alone for the induction of labor in women with intrauterine fetal death.
  
  
  METHODS
  A randomized double blind placebo-controlled parallel group superiority trial was conducted. One hundred and ten women who had experienced fetal death at or later than 20 weeks of gestation were randomized by computer-generated random number sequence to receive 200 mg of mifepristone or matched placebo tablets orally. Misoprostol was administered vaginally to women of both groups after 36-48 h. The main outcomes studied were the fetal-placental delivery rate within 24 hours of commencement of the first dose of misoprostol without additional intervention and the induction-delivery interval.
  
  
  RESULTS
  Successful delivery occurred significantly more frequently in women who received mifepristone prior to misoprostol than in women who received only misoprostol (92.5% [49/53] compared with 71.2% [37/52] respectively; P = 0.001). The mean induction-delivery interval was also significantly shorter when using mifepristone plus misoprostol than using misoprostol alone (9.8 h, standard deviation, 4.4 compared with 16.3 h standard deviation, 5.7, respectively; P < 0.001).
  
  
  CONCLUSIONS
  Use of a combination of mifepristone and misoprostol significantly improved the rate of successful delivery and shortened the induction-delivery interval in women who had experienced fetal death compared with the use of misoprostol alone.
authors.affiliation: Department of Obstetrics and Gynecology, Nilratan Sircar Medical College, West Bengal University of Health Sciences, Kolkata, India.
authors.forename: Picklu
authors.initials: P
authors.lastname: Chaudhuri
authors.affiliation: Department of Obstetrics and Gynecology, Nilratan Sircar Medical College, West Bengal University of Health Sciences, Kolkata, India.
authors.forename: Sutapa
authors.initials: S
authors.lastname: Datta
mesh_terms: D000328:Adult; D004311:Double-Blind Method; D005260:Female; D005313:Fetal Death; D006801:Humans; D007751:Labor, Induced / Q000379:methods*; D015735:Mifepristone / Q000008:administration & dosage* / Q000009:adverse effects; D016595:Misoprostol / Q000008:administration & dosage* / Q000009:adverse effects; D011247:Pregnancy
chemical_list: D016595:Misoprostol; D015735:Mifepristone
keywords: induction of labor; intrauterine fetal death; mifepristone; misoprostol