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Mifepristone and misoprostol compared with misoprostol alone for induction of labor in intrauterine fetal death: A randomized trial
Author(s) -
Chaudhuri Picklu,
Datta Sutapa
Publication year - 2015
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.12815
Subject(s) - misoprostol , medicine , mifepristone , obstetrics , placebo , labor induction , gestation , randomized controlled trial , fetal death , induction of labor , pregnancy , fetus , abortion , gynecology , oxytocin , surgery , genetics , alternative medicine , pathology , biology
Aim To assess whether mifepristone and misoprostol are more beneficial than misoprostol alone for the induction of labor in women with intrauterine fetal death. Methods A randomized double blind placebo‐controlled parallel group superiority trial was conducted. One hundred and ten women who had experienced fetal death at or later than 20 weeks of gestation were randomized by computer‐generated random number sequence to receive 200 mg of mifepristone or matched placebo tablets orally. Misoprostol was administered vaginally to women of both groups after 36–48 h. The main outcomes studied were the fetal‐placental delivery rate within 24 hours of commencement of the first dose of misoprostol without additional intervention and the induction‐delivery interval. Results Successful delivery occurred significantly more frequently in women who received mifepristone prior to misoprostol than in women who received only misoprostol (92.5 % [49/53] compared with 71.2% [37/52] respectively; P = 0.001). The mean induction‐delivery interval was also significantly shorter when using mifepristone plus misoprostol than using misoprostol alone (9.8 h, standard deviation, 4.4 compared with 16.3 h standard deviation, 5.7, respectively; P < 0.001). Conclusion Use of a combination of mifepristone and misoprostol significantly improved the rate of successful delivery and shortened the induction‐delivery interval in women who had experienced fetal death compared with the use of misoprostol alone.