Abstract: Background: Various methods are available to induce labor in intrauterine fetal death. One such regimen is medical management using a combination of Mifepristone and Misoprostol, which is well established in the management of third trimester termination of pregnancy.
Methods: An Observational prospective study was carried out at Gynaecology and Obstetrics department of Chittagong Medical College Hospital, Chittagong, between 01/07/2019 to 31/12/2019. Pregnant women with intrauterine fetal death after 28 weeks of gestation admitted in CMCH, Chittagong, Bangladesh. Patients who received combination of Mifepristone with misoprostol and misoprostol alone were considered as group I and Group II respectively in the management of intrauterine fetal death. Data were collected from selected patient. Detailed history and thorough clinical examination was performed following a pre tested questionnaire but only after taking informed consent of the patient.
Result: The mean age was found 27.9±5.6 years in group I and 27.7±4.3 in group II. The mean systolic blood pressure was found 101.7±14.0 mmHg in group I and 106.1±15.4 mmHg in group II. The mean diastolic blood pressure was found 66.6±9.9 mmHg in group I and 70.1±12.5 mmHg in group II. The mean Bishop's score was found 7.8±2.5 in group I and 8.2±2.6 in group II. Majority (60.0%) patients in group I, received 2nd dose (4hrs). In group II, most (40.0%) of the patients, received 3rd dose (8 hrs). The mean induction to delivery interval was found 8.6±2.0 in group I and 15.1±3.5 in group II. 16(32.0%) patients in group I and 41(82.0%) in group II developed fever. 16 (16.0%) patients had diarrhea in group I and 11(22.0%) in group II.
Conclusion: Combination of mifepristone with misoprostol is more effective in terms of reducing of induction delivery interval, though the side effects in between two groups were almost similar. Both regimens are safe for induction of labour in intrauterine fetal death. Therefore, the use of combination method for induction of labour in intrauterine fetal death, needs to be considered in the management.
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