Role of Combination OF Mifepristone and Misoprostol Verses Misoprostol alone in Induction of Labour in Late Intrauterin Fetal Death: A Prospective Study
- PMID: 24971122
- PMCID: PMC4064752
Role of Combination OF Mifepristone and Misoprostol Verses Misoprostol alone in Induction of Labour in Late Intrauterin Fetal Death: A Prospective Study
Abstract
Objective: To compare efficacy, safety and tolerance of combination of mifepristone and misoprostol versus misoprostol-only in induction of late intrauterine fetal death (IUFD).
Materials and methods: This prospective study included a consecutive series of 52 women gravid up to fourth with IUFD after 28 weeks of gestation between January 2008 and June 2011. Women were divided into two groups. First group of women received a single oral dose of 200mg mifepristone, and after 24 hours, 100ug of intravaginal misoprostol was administered, followed by intravaginal 100µg misoprostol at four hourly intervals if required. Second group of women received 100 µg misoprostol at four hourly interval per vaginally (maximum 600µg in 24 hours). Oxytocin was given for augmentation if needed.
Results: The induction-to-delivery time was shorter with the combination regimen (p < 0.001) group. The total dose of misoprostol needed was lower in the group pre-treated with mifepristone (p < 0.001). Oxytocin was required only in misoprostol group. The two groups did not differ as regards complications experienced during labor and delivery significantly.
Conclusion: Both regimens, misoprostol-only and the combination of mifepristone and misoprostol are safe in induction of labor after intrauterine fetal death (IUFD). Pre-treatment with mifepristone is more effective in terms of reducing of induction delivery interval, requirement of lesser dose of misoprostol and no need of augmentation with oxytocin.
Keywords: Induction of Labour; Intrauterine Fetal Death; Mifepristone; Misprostol.
Similar articles
-
A Comparison of the Efficacy and Safety of Mifepristone and Misoprostol Versus Misoprostol alone for Induction of Labour in Nigerian Women with Intrauterine Fetal Death: A Triple Blind Randomized Controlled Trial.Niger J Clin Pract. 2024 Feb 1;27(2):159-166. doi: 10.4103/njcp.njcp_786_22. Epub 2024 Feb 26. Niger J Clin Pract. 2024. PMID: 38409142 Clinical Trial.
-
Misoprostol-only versus mifepristone plus misoprostol in induction of labor following intrauterine fetal death.Acta Obstet Gynecol Scand. 2007;86(6):701-5. doi: 10.1080/00016340701379853. Acta Obstet Gynecol Scand. 2007. PMID: 17520402
-
Induction of Labor Using Misoprostol With or Without Mifepristone in Intrauterine Death.JNMA J Nepal Med Assoc. 2014 Apr-Jun;52(194):785-90. JNMA J Nepal Med Assoc. 2014. PMID: 26905705 Clinical Trial.
-
Inducing labor after fetal demise: a systematic review and meta-analysis of the efficacy and safety of mifepristone and misoprostol combination versus misoprostol alone.BMC Pregnancy Childbirth. 2025 Apr 12;25(1):435. doi: 10.1186/s12884-025-07528-w. BMC Pregnancy Childbirth. 2025. PMID: 40221656 Free PMC article.
-
Intrauterine fetal death after previous caesarean birth: Inducing labour: Evidence review D.London: National Institute for Health and Care Excellence (NICE); 2021 Nov. London: National Institute for Health and Care Excellence (NICE); 2021 Nov. PMID: 35438863 Free Books & Documents. Review.
References
-
- Newhall EP, Winikoff B. Abortion with mifepristone and misoprostol: regimens, efficacy, acceptability and future directions. Am J Obstet Gynecol. 2000;183:S44–53. - PubMed
-
- El-Refaey H, Rajasekar D, Abdalla M, Calder L, Templeton A. Inductionof abortion with mifepristone (RU 486) and oral or vaginal misoprostol. N Engl J Med. 1995;332:983–7. - PubMed
-
- Wagaarachchi PT, Ashok PW, Narvekar NN, Smith NC, Templeton A. Medical management of late intrauterine death using a combination of mifepristone and misoprostol. BJOG. 2002;109:443–7. - PubMed
-
- Vayrynen W, Heikinheimo O, Nuutila M. Misoprostol-only versus mifepristone plus misoprostol in induction of labor following intrauterine fetal death. Acta Obstetriciaet Gynecologica Scandinavica. 2007;86:701–5. - PubMed
-
- De Heus R, Graziosi G, Christiaens G, Bruinse H, Mol B. Medical management for termination of second and third trimester pregnancies : a comparison strategies. Eur J Obstet Gynecol Reprod Biol. 2004;116:16–21. - PubMed
LinkOut - more resources
Full Text Sources
Research Materials