Effectiveness of Misoprostol in the Management of Intra-Uterine Foetal Death

Background: Misoprostol – a prostaglandin E1 analogue is effective in the induction of labour in the 2nd and 3rd trimester pregnancies. There is paucity of information in the use of misoprostol for labour induction in our setting. Method: Non-randomized clinical trial. Results: Thirty-four consecutive patients with real time ultrasonographically confirmed intrauterine fetal demise from 14 weeks gestation were recruited into the study. Twelve patients had oral administration while 22 were given misoprostol via the vaginal route. The mean age and parity of these patients where 26.7 ± 6.8 years and 3.2 ± 3.3 respectively. The mean uterine size at induction was 24.5 ± 8.2 weeks. Mean onset of painful uterine contractions was 5.02 ± 5.2 hours (Range 0.5 – 22 hours) while the mean induction – delivery interval was 14.6 ± 10.4 hours (Range 3-46 hours). The success rate of induction was 100% within 48 hours. Induction – delivery interval was not dependent on uterine size/Gestational age. Side effects encountered were minor namely nausea and vomiting. There were more side effects on oral administration. Conclusion: Misoprostol is effective in the termination of 2nd and 3rd trimester pregnancies associated with intrauterine fetal demise. Studies are needed to compare the efficacy of misoprostol with oxytocin in the induction of labour with live fetuses in our setting.