title: [Methods of induction of labor in termination of pregnancy after 22weeks: About 3procedures].
abstract: OBJECTIVE
  To propose a protocol for induction of labor to terminate pregnancy after 22weeks of amenorrhea allowing to decrease the duration of labor and of hospitalization but also, allowing to reduce the number of emergency pretreatment-induced fetal death, to improve the experience of the patients and to limit the cost.
  
  
  METHODS
  We realized a retrospective single-center study including 269patients and comparing three protocols, with and without laminaria and with various intervals mifepristone-misoprostol (14 and 38hours). The outcome measures were the misoprostol-delivery interval, the delivery time and the number of emergency pretreatment-induced fetal death.
  
  
  RESULTS
  We showed that the misoprostol-delivery interval and the delivery time were comparable for the three periods of our study, even after decrease of 24hours of the mifepristone-misoprostol interval and in the absence of laminaria. The misoprostol-delivery interval was between 7h30 and 8h35 between protocols (P=0.055). The delivery time was between 5:18pm and 6:48pm between protocols (P=0.252). The early administration of misoprostol allowed the patients to give birth earlier (P=0.001). Finally, we showed that the increase of the size and the number of laminarias were risk factors of emergency pretreatment-induced fetal death (respectively P=0.013 and P=0.002).
  
  
  CONCLUSIONS
  The absence of laminaria and the reduction of the interval mifepristone-misoprostol of 24hours do not change the time to delivery and allow to reduce the duration of hospitalization, the number of emergency pretreatment-induced fetal death and the cost of the TOP.
authors.affiliation: Pôle mère-enfant, hôpital Nord, chemin des Bourrely, 13015 Marseille, France. Electronic address: couteau.cecile@yahoo.com.
authors.forename: C
authors.initials: C
authors.lastname: Couteau
authors.affiliation: Pôle mère-enfant, hôpital Nord, chemin des Bourrely, 13015 Marseille, France.
authors.forename: C
authors.initials: C
authors.lastname: D'Ercole
authors.affiliation: Pôle mère-enfant, hôpital Nord, chemin des Bourrely, 13015 Marseille, France.
authors.forename: F
authors.initials: F
authors.lastname: Bretelle
authors.affiliation: Pôle mère-enfant, hôpital Nord, chemin des Bourrely, 13015 Marseille, France.
authors.forename: L
authors.initials: L
authors.lastname: Boubli
authors.affiliation: Pôle mère-enfant, hôpital Nord, chemin des Bourrely, 13015 Marseille, France.
authors.forename: B
authors.initials: B
authors.lastname: Guidicelli
authors.affiliation: Pôle mère-enfant, hôpital Nord, chemin des Bourrely, 13015 Marseille, France.
authors.forename: C
authors.initials: C
authors.lastname: Chau
mesh_terms: D000019:Abortifacient Agents / Q000008:administration & dosage* / Q000494:pharmacology; D000028:Abortion, Induced / Q000379:methods* / Q000706:statistics & numerical data; D000328:Adult; D005260:Female; D006801:Humans; D007751:Labor, Induced / Q000379:methods* / Q000706:statistics & numerical data; D007795:Laminaria; D015735:Mifepristone / Q000008:administration & dosage* / Q000494:pharmacology; D016595:Misoprostol / Q000008:administration & dosage* / Q000494:pharmacology; D010043:Outcome and Process Assessment, Health Care; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011263:Pregnancy Trimester, Third; D012189:Retrospective Studies
chemical_list: D000019:Abortifacient Agents; D016595:Misoprostol; D015735:Mifepristone
keywords: Fœticide; Interruption médicale de grossesse; Laminaire; Laminaria; Mifepristone; Mifépristone; Misoprostol; Pretreatment-induced fetal death; Termination of pregnancy