INDUCTION OF LABOR WITH INTRAVAGINAL MISOPROSTOL IN INTRAUTERINE FETAL DEATH

OBJECTIVE: Our purpose was to evaluate the effectiveness and safety of intravaginal misoprostol for the induction of labor in intrauterine f etal death. STUDY DESIGN: Seventy-two women at 18 to 40 weeks of pregn ancy with intrauterine fetal death, without abdominal scars, were trea ted with 100 mu g of intravaginal misoprostol. The dose was repeated e very 12 hours until effective uterine contractions and cervical dilata tion were obtained, for up to 48 hours. RESULTS: The mean time from in duction to delivery was 12.6 hours, and only six patients (8%) require d between 24 and 48 hours, at the end of which all patients had been d elivered. Only the Bishop's score was significantly associated with ti me from first dose to expulsion. No surgical procedure was required. H ypercontractility, sweating, fever, diarrhea, or other gastrointestina l effects were not detected. There was no need for analgesics. CONCLUS IONS: Intravaginal misoprostol at the dose of 100 mu g every 12 hours appears to be a safe, effective, practical, and inexpensive new method for induction of labor in intrauterine fetal death.