scholarly journals Comparative study of mifepristone and misoprostol versus misoprostol alone in induction of labour in late intrauterine fetal death

2018 ◽  
Vol 7 (3) ◽  
pp. 987
Author(s):  
Hemalatha K. R. ◽  
Qutejatul Kubra Mulla
Keyword(s):  
Fetal Death ◽  
Induction Of Labour ◽  
Intrauterine Fetal Death ◽  
Combination Regimen ◽  
Intrauterine Death ◽  
Group I ◽  
Oral Misoprostol ◽  
Undesirable Consequence ◽  
Group Ii ◽  
A Prospective Study

Background: Intrauterine fetal death is most undesirable consequence of pregnancy and stressful condition for women and family and for health professional. Naturally, majority of women (over 90%) go in for spontaneous labour and deliver within 3 weeks of intrauterine death. Prolonged retention of dead fetus in utero has complications like DIC, psychological stress and infection. Various methods are available to induce labor in intrauterine fetal death. One such regimen is medical management using a combination of Mifepristone and Misoprostol. The objective of this study was to compare efficacy and safety of combination of mifepristone and misoprostol versus misoprostol only in induction of labour in late intrauterine fetal death.Methods: A prospective study was carried out in KIMS, Hubli between Jan 2014 to Dec 2015.Data from 100 women with intrauterine fetal death between gestational age of 24-42 weeks were analysed. They were divided into 2 groups of 50 each. Group I received single oral dose of 200mg mifepristone followed 24 hours later with oral misoprostol (100µg-50µg) every 4 hourly. Group II received only misoprostol. Outcomes were measured in terms of induction to delivery interval and number of misoprostol doses required.Results: Mean induction to delivery interval in Group I was 8.3 hours versus13.4 hours in Group II. Induction delivery interval was shorter in combined regimen. Total dose of misoprostol was also less in Group I.Conclusions: Both regimens are safe for induction of labour in late intrauterine fetal death. However, the induction delivery interval and dose of misoprostol required was decreased in combination regimen.

scholarly journals A prospective study of intrauterine death cases at a tertiary care hospital

2021 ◽  
Vol 10 (2) ◽  
pp. 638
Author(s):  
Nabila N. Tai ◽  
Rinku Mulchandani ◽  
Dipti A. Modi ◽  
Bijal Rami
Keyword(s):  
Prospective Study ◽  
Fetal Death ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Intrauterine Fetal Death ◽  
Intrauterine Death ◽  
Care Hospital ◽  
Risk Pregnancy ◽  
A Prospective Study ◽  
Death Cases

Background: Intrauterine fetal death is defined as foetus with no signs of life in utero after 20 weeks of gestations. Stillbirth is a useful index to measure the values of antenatal and intra-natal care. Intrauterine fetal death is due to various causes whether it be maternal causes, fetal causes or placental causes.Methods: It was a prospective study, conducted at SSG hospital, Vadodara over a period of 1 year from January 2019 to December 2019. All pregnant women coming to labour room with intrauterine fetal death with gestation age more than 28 weeks were included in study. It included complaints on admission, obstetric profile, mode of delivery, fetal outcomes, placental examination, condition of cord and investigation reports.Results: During the study period of one year, a total of 462 intrauterine fetal deaths were reported amongst 7295 deliveries conducted during the study period. Incidence rate calculated was 63/1000 births. Many of the intrauterine fetal death cases were associated with pregnancy induced hypertension and antepartum hemorrhage. Out of all intrauterine death cases, 410 cases delivered vaginally. Congenital anomalies were also found to be associated with intrauterine death cases.Conclusions: High risk pregnancy cases should be identified during routine antenatal check-ups so that intrauterine fetal death can be prevented. The mode of antepartum and intrapartum surveillance for fetal wellbeing should be advanced to prevent fetal demise.

TO COMPARE THE EFFECTIVENESS OF EXTRA-AMNIOTIC SALINE INSTILLATION THROUGH FOLEY CATHETER PRIOR TO ORAL MISOPROSTOL WITH ORAL MISOPROSTOL ALONE IN INDUCING LABOUR IN PREGNANCIES >28 WEEKS WITH INTRAUTERINE FOETAL DEATH- A RANDOMIZED CONTROLLED TRIAL AT TE

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Kamlesh Yadav ◽  
Shilpee Singh
Keyword(s):  
Birth Weight ◽  
Foley Catheter ◽  
Study Groups ◽  
Induction Of Labour ◽  
Foetal Death ◽  
Group I ◽  
Oral Misoprostol ◽  
The Mean ◽  
Group Ii ◽  
Saline Instillation

Background: The present study aims to compare the results of EASI followed by oral misoprostol and oral misoprostol alone for induction of labour in pregnancies of more than 28 weeks with intrauterine foetal death. Methods: The present observational and prospective study is an attempt to compare the efficacy of extra-amniotic saline instillation with Foley catheter prior to oral misoprostol and oral misoprostol alone in induction of labour of pregnancies more than 28 weeks with intrauterine fetal death. Results: Most of the cases delivered vaginally in both study groups. The mean induction delivery time in group I was higher than group II and the results were statistically significant on comparing both groups. In group I, 78% cases were delivered within 24 hours whereas in group II 96% cases delivered within 24 hours of induction. There was no significant difference in the mean number of required misoprostol in both groups (p>0.05). Need of supplementation with oxytocin was more in group I as compared to group II and the p value is significant (p<0.01). Mean birth weight in group I was 2.25±0.75 kg and in group II was 2.27±0.77 kg. Maximum number of babies had birth weight between 1.52-2.50 kg with 44% in group I and 40% in group II (p>0.05). Only 4 cases had uterine tachysystole and only 1case had postpartum pyrexia. Very few complications were recorded in both the study groups (p>0.05). Conclusion: We concluded that oral misoprostol tablet alone is more effective at inducing and setting up the active labour in pregnancies of >28 weeks with intrauterine foetal death than EASI followed by oral misoprostol. It is inexpensive, has a long shelf life, can be easily stored at room temperature and patient remains ambulatory after induction with oral misoprostol. Oral misoprostol alone seems to have an edge over extra-amniotic saline instillation followed by oral misoprostol in all aspects. Keywords: Misoprostol, Extra-amniotic saline, Induction of labour.

Morphological features of dichorionic triamniotic triplet pregnancy complicated by intrauterine death of two fetuses in the surrogacy program

2021 ◽  
Vol 20 (3) ◽  
pp. 169-173
Author(s):  
N.S. Trifonova ◽  
E.E. Rudenko ◽  
K.I. Lavrent'eva ◽  
L.S. Aleksandrov ◽  
E.V. Zhukova ◽  
...  
Keyword(s):  
Fetal Death ◽  
Multiple Pregnancy ◽  
Immunological Tolerance ◽  
Intrauterine Fetal Death ◽  
Intrauterine Death ◽  
Term Pregnancy ◽  
Triplet Pregnancy ◽  
The Third ◽  
Pregnancy And Delivery ◽  
Live Fetus

A clinical case of management of a pregnant woman (surrogacy) with dichorionic triamniotic triplets, self-reduction of one fetus from triplets in the gestation period of 13 weeks, intrauterine death of the second fetus at week 20 of pregnancy and delivery of the third live fetus in full-term pregnancy. Key words: surrogacy, triplets, multiple pregnancy, intrauterine fetal death, immunological tolerance

scholarly journals Role of Combined Mifepristone and Misoprostol Verses Misoprostol Alone in Induction of Labour in Patients with Intrauterine Foetal Death - a Randomized Comparison Between their Outcome

2017 ◽  
Vol 8 (1) ◽  
pp. 50-54
Author(s):  
Sharmin Abbasi ◽  
Sehereen Farhad Siddiqua ◽  
Mohammad Noor A Alam ◽  
Suha Jesmin ◽  
Md Mahmudur Rahman Siddiqui ◽  
...  
Keyword(s):  
Fetal Death ◽  
Research Work ◽  
Medical College Hospital ◽  
Induction Of Labour ◽  
Intrauterine Fetal Death ◽  
College Hospital ◽  
Medical College ◽  
Misoprostol Group ◽  
Group A ◽  
Group B

Background: Intrauterine fetal death is means- intrapartum death after the fetus has reached the age of viability8. As in IUFD journey, labor pain will be fruitless. So, it is of utmost importance to search for the method which can reduce hours of pain in labor of IUFD cases.Metarials Methods: In this research work patients divided in two groups. Induction of labour in one group was given by combination of mifepristone and misoprostol other group by misoprostol only and we try to find out the best method. To compare the effectiveness, induction to delivery interval, safety and side effects of combination of mifepristone and misoprostol versus conventional use of misoprostol alone in induction of labour in patients with intrauterine fetal death. It is a Prospective randomized comparative study in Anwer Khan Modern Medical College Hospital and Dhaka Medical College Hospital among 70 patients with IUFD after 28 weeks of gestation during January 2014- January 2016.Result: We allowed the patients up to third gravid and after 28 weeks of gestation. Patients were grouped as Group A(35) & Group B (35). In Group A Induction was given by single oral dose of 200 mg mifepristone, and after 48 hours, tab. Misoprostol in post. fornix started if <34 weeks-100 ?gm dose and >34 weeks-50 ?gm dose. Doses were repeated every 6 hourly intervals if required. In Group B Induction was given by 100 ?gm misoprostol at 6 hourly interval in post. Fornix. In both groups we allowed misoprostol maximum 600 ?gm. Oxytocin was given for augmentation if needed. The two study groups did not differ demographically. Induction to delivery time was shorter with combined regimen group (P<0.001). Induction to delivery interval ranges from 10-12 hours in mifepristone plus misoprostole group.In only misoprostol group it was about 24-26 hours. Doses of misoprostol was lower in combined group (P<0.001). 4 patients need Oxytocin for augmentation in only misoprostol group. In combined group oxytocin was not needed. The two groups did not differ as regards complications experienced during labour and delivery significantly. In overall out come 2 failed induction in misoprostol only group but not in combinedgroup.Conclusion: In Induction of IUFD mifepriston plus misoprostol is an effective combined group. It is safe, non invasive, easily tolerable, highly cost effective, had less induction to delivery interval, required less dose of misoprostol and no need of augmentation with oxytocin. So,the combined group is more effective than conventional regimen of misoprostol alone.Anwer Khan Modern Medical College Journal Vol. 8, No. 1: Jan 2017, P 50-54

INDUCTION OF LABOUR WITH MIFEPRISTONE AFTER INTRAUTERINE FETAL DEATH

The Lancet ◽  
1985 ◽  
Vol 326 (8462) ◽  
pp. 1019 ◽  
Author(s):  
D. Cabrol ◽  
M.Bouvier D'Yvoire ◽  
E. Mermet ◽  
L. Cedard ◽  
C. Sureau ◽  
...  
Keyword(s):  
Fetal Death ◽  
Induction Of Labour ◽  
Intrauterine Fetal Death

scholarly journals Abdominal pregnancy misdiagnosed as an intrauterine pregnancy: a cause of failed induction of labour for fetal death

2019 ◽  
Vol 8 (8) ◽  
pp. 3382
Author(s):  
Nkencho Osegi ◽  
Olakunle I. Makinde ◽  
Peter O. Eghaghe ◽  
Zakaa Zawua ◽  
Bright N. Ohaka
Keyword(s):  
Maternal Mortality ◽  
Preoperative Diagnosis ◽  
Fetal Death ◽  
Delayed Diagnosis ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Induction Of Labour ◽  
Intrauterine Fetal Death ◽  
Abdominal Pregnancy ◽  
Intrauterine Pregnancy

Abdominal pregnancy is a rare form of ectopic pregnancy usually associated with fetal death among other complications, although very rare cases of live births have been reported. There is also a high risk of maternal mortality. A high index of suspicion is required to make a preoperative diagnosis as diagnosis from history, examination and ultrasound is often missed. Misdiagnoses as an intrauterine pregnancy usually occur. This misdiagnosis makes management of patients with an abdominal pregnancy a challenge and may affect treatment outcome. We managed a 35 year old pregnant multipara who was referred to us on account of repeated failed attempts at induction of labour for intrauterine fetal death. Three obstetric ultrasound scans done during the course of patient’s management reported an intrauterine dead fetus. We also failed to achieve uterine evacuation. We resorted to carry out a hysterotomy and following laparotomy, we found an abdominal pregnancy. This finding was unexpected by us, however, we delivered the dead fetus and was able to successfully manage the placenta. Discovering an abdominal pregnancy at surgery carried out for a supposed intrauterine pregnancy is usual for many cases of abdominal pregnancy. Clinicians should be aware of the clinical signs and symptoms that raise a suspicion of abdominal pregnancy as prompt preoperative diagnosis of abdominal pregnancy helps to plan and offer early and appropriate intervention. This reduces the incidence of maternal mortality usually due to massive intra-abdominal haemorrhage arising from delayed diagnosis and poor placenta management.  

scholarly journals Effectiveness of low dose versus high dose oxytocin regimen for induction of labour

2021 ◽  
Vol 10 (5) ◽  
pp. 1948
Author(s):  
Paridhi Gupta ◽  
Indu Chawla ◽  
Sonal Gupta
Keyword(s):  
Dose Regimen ◽  
Dose Group ◽  
Low Dose ◽  
Induction Of Labour ◽  
High Dose ◽  
High Dose Regimen ◽  
Nulliparous Women ◽  
Group I ◽  
Significant Difference ◽  
Group Ii

ABSTRACTBackground: Induction of labour is an indispensable part of modern obstetrics and certainly one of the most frequently performed obstetric procedure in the world. Oxytocin, being the most common inducing agent with multiple protocols being practiced, further research is required for the establishment of better protocol with optimal maternal and neonatal outcomes.Methods: Randomized comparative study including 100 term nulliparous women (randomized into high dose, group-I and low dose, group-II with 50 patients in each group) was done. High dose regimen was started with 4mu/min with increment of 4mu/min up to a maximum of 32mu/min and low dose regimen was started with 2mu/min with increment of 2mu/min up to a maximum of 32mu/min. Induction to delivery interval was the primary outcome. Secondary outcomes noted were rate of caesarean section, tachysytole with or without fetal distress, failed induction, maternal outcomes like need for instrumental vaginal delivery, PPH and choriamnionitis, neonatal outcomes like NICU admission, umbilical cord pH and apgar score.Results: There was significant reduction seen in induction to delivery interval among those induced with high dose oxytocin regimen. It was found to be 6.96±3.77 hours in group-I and 9.05±4.65 hours in group-II (p value 0.034). Though incidence of tachysystole was more in high dose regimen, it was not statistically significant. No significant difference was seen in secondary outcomes.Conclusions: On the basis of present study, high dose oxytocin regimen can be considered for induction of labour as it has same effects as that of low dose regimen with lesser induction to delivery interval.

scholarly journals Management of stillbirths: an observational analysis at a rural tertiary care centre in Kerala, India

2019 ◽  
Vol 8 (4) ◽  
pp. 1583
Author(s):  
Ajini K. K. ◽  
Reena R. P. ◽  
Radha K. R.
Keyword(s):  
Cesarean Section ◽  
Fetal Death ◽  
Tertiary Care ◽  
Induction Of Labour ◽  
Intrauterine Fetal Death ◽  
Elective Cesarean Section ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Elective Cesarean ◽  
Previous Cesarean

Background: Stillbirth is a distressing event, both for the expecting mother and the obstetrician. Several maternal, social and circumstantial factors influence its occurrence. These women with intrauterine fetal death need to be treated in a considerate manner. Our aim was to analyse different methods   of induction, management of labour and their outcomes in women with antepartum fetal demise.Methods: All women admitted to a tertiary care centre with intrauterine fetal death after 22 weeks during the study period of 24 months were recruited. Maternal sociodemographic characteristics and relevant investigations were studied. Induction of labour was achieved with mechanical and pharmacological methods.  Stillborn babies, placentae and umbilical cord were examined after delivery.Results: There were 175 women with IUFD   admitted during the study period. The stillbirth rate was 38.6 per1000 live births.148 women (84.57%) required induction of labour while16 women had spontaneous onset of labour. Among the 44 women with previous Cesarean section, 11 underwent elective Cesarean section. 19 women (57.6%) out of 33 cases of trial of labour after Cesarean had a successful vaginal delivery. There were 2 cases of rupture uterus and 10 women required ICU admissions. Intrauterine growth restriction was the leading cause of stillbirth (41.8%) followed by hypertensive disorders (27.7%).Conclusions: Present study has shown that vaginal birth can be achieved in most women with mechanical and pharmacological methods of induction within a reasonable period of time.

scholarly journals Decision to delivery interval in emergency cesarean section and its association with perinatal outcome

2021 ◽  
Vol 12 (8) ◽  
pp. 100-104
Author(s):  
Fareha Khatoon ◽  
Amrita Singh ◽  
Sumaiya Shamsi ◽  
Ayesha Ahmad ◽  
Nikunj Teotia
Keyword(s):  
Perinatal Outcome ◽  
Clinical Excellence ◽  
Demographic Variables ◽  
Outcome Analysis ◽  
Time Interval ◽  
Induction Phase ◽  
Emergency Cesarean ◽  
Group I ◽  
Group Ii ◽  
A Prospective Study

Background: Decision to delivery [DDI] interval is the time interval between decision for caesarean section [CS] and delivery of baby. The ideal DDI for emergency CS is not known; there is controversy over the best DDI to avoid preventable perinatal morbidity and mortality. Aims and Objectives: This study was conducted to find out the DDI we could achieve for Category-1 and Category-2 CS and evaluate our findings against the recommendations by National Institute for Clinical Excellence [NICE]. We also studied the association of DDI with perinatal outcome and explored the reasons for prolongation of DDI. Materials and Methods: This was a prospective study conducted over a period of 6 months. All women who underwent CS and meeting the inclusion criteria were recruited for the study. DDI was calculated as the time interval between decision making and delivery of baby, in minutes [min]. Data was collected for maternal socio-demographic variables, CS indication and complications and perinatal outcome. Analysis was done using SPSS version 21.0. Results: Ninety out of one hundred eighty-one CS was evaluated. Cases were grouped as Group I [including cases where we could achieve the recommended DDI] and Group II [including cases where we could not achieve the recommended DDI]. The average DDI was 55.04 min for category- 1 and 55.13 for category-2 CS. For Category-1 CS, all the cases qualified for entry into Group II because we could not achieve a DDI of 30 min. For Category-2 CS there were 22 cases in Group I and 14 cases in Group II. There was no difference in perinatal outcome between the groups. Conclusion: It was not feasible to achieve the 30 min DDI for Category-1 CS in the present study. The DDI of 30-75 min for Category-2 could be achieved in 61.11% cases. The most common reason for failure to achieve the recommended DDI was related to issues with anaesthesia in the pre-operative room as well as inside the theatre in the pre-induction phase. Delay in category-2 CS was not associated with poor perinatal outcome.

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