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08.01.2018 | Original Article | Ausgabe 1/2019

The Journal of Obstetrics and Gynecology of India 1/2019

Current Practices of Cervical Ripening and Induction of Labour in Intrauterine Foetal Demise: An Observational Study

Zeitschrift:
The Journal of Obstetrics and Gynecology of India > Ausgabe 1/2019
Autoren:
Kinnari V. Amin, Anahita R. Chauhan, Anchal Goel
Wichtige Hinweise
Kinnari V. Amin is an Ex-Registrar, Department of Obstetrics and Gynecology, Seth G. S. Medical College and K.E.M. Hospital, Mumbai, Maharashtra, India. Anahita R. Chauhan is a Former Professor and Head of Unit, Department of Obstetrics and Gynecology, Seth G.S. Medical College and K.E.M. Hospital, Mumbai, Maharashtra, India. Anchal Goel is an Ex-Registrar, Department of Obstetrics and Gynecology, Seth G.S. Medical College and K.E.M. Hospital, Mumbai, Maharashtra, India.

Abstract

Background

Objectives of the current study were to find the most effective method of induction of labour in case of intrauterine foetal death (IUFD), with efficacy described as least induction-to-delivery time, and the agent with the best safety profile, i.e. least maternal complications.

Methods

This was a prospective observational descriptive study carried out between January and November 2015 in a tertiary care centre. Hundred consecutive cases of IUFD after 20 weeks of gestation requiring induction of labour and fulfilling inclusion criteria were selected. The method of induction decided by each consultant was noted, and results were analysed. As this was a purely observational study, all agents used for induction of labour (misoprostol, dinoprostone gel, intracervical Foley catheter) and all dose variations were included.

Results

The induction-to-delivery interval was shortest with dinoprostone (12.52 h) followed by Foley catheter (13.28 h) and misoprostol (15.82 h). However, the p value (0.301) was not statistically significant. Misoprostol was used more often in second trimester, while dinoprostone gel was most commonly used in third trimester. Failure occurred in 3 cases; all required lower segment caesarean section (LSCS). No significant complications were associated with any of the methods.

Conclusions

Dinoprostone gel, misoprostol and Foley catheter are safe for induction of labour in all cases of IUFD, even for those with previous LSCS with IUFD.

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