Abstract: Background and Objectives
: A prospective observational cohort study was conducted to evaluate the effectiveness and side effects of vaginal misoprostol in the termination of second and third trimester pregnancies complicated with intrauterine fetal death.
Material and Methods: The present study was conducted at the Department of Obstetrics and Gynaecology, Maharajah’s Institute of Medical Sciences, Nellimarla, Vizianagaram (Dist.), Andhra Pradesh state, India. The study subjects constituted n = 100 women subjects with intrauterine fetal demise in second and third trimester pregnancies collected from the hospital attached to the Maharajah’s Institute of Medical Sciences. All the study group participants were subjected to history taking, physical examination, Bishop scoring, application of 25µg of misoprostol in the posterior fornix of vagina every fourth hourly over 24 hours. The progress, adverse effects and outcomes were assessed.
Results: The success rate was 92.76% and 64.52% in the subjects with third and second trimesters respectively. The mean induction-delivery interval was 15.67 ± 9.64 and 24.94 ± 8.23 for women participants with third and second trimesters respectively. The induction-delivery interval correlated negatively with the duration of gestation. The mean value of total required dose of misoprostol was 192.42 ± 128.99 and 361.29 ± 139.92 for the subjects with third and second trimesters respectively.
Conclusion: Low dose Misoprostol appears to be a safe, effective, practical and inexpensive method for termination of third trimester pregnancies compared to second trimester pregnancies complicated with intrauterine fetal death and its effects increases with duration of gestation.