Induction of labour in pregnancies with fetal demise: a randomised control trial

Authors

  • Sanjay Prabhasbhai Parmar Department of Obstetrics and Gynecology, Medical College and SSG Hospital, Baroda, Gujarat, India
  • Maitri Chetan Shah Department of Obstetrics and Gynecology, Medical College and SSG Hospital, Baroda, Gujarat, India
  • Shipra Kumari Department of Obstetrics and Gynecology, Medical College and SSG Hospital, Baroda, Gujarat, India
  • Vishnu Harkhabhai Solanki Department of Obstetrics and Gynecology, Medical College and SSG Hospital, Baroda, Gujarat, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20231554

Keywords:

Induction of labour, IUFD, Mifepristone, Misoprostol, Transcervical Foley’s catheter

Abstract

Background: The present study aims at comparing efficacy and safety of two different regimens of induction of labour (IOL) in pregnancies with fetal demise.

Settings and Design: A randomised controlled trial was conducted on 100 eligible pregnant women diagnosed with intrauterine fetal demise who were admitted in the labour ward of a tertiary care hospital.

Methods: All participants were randomly divided into two groups in group A and group B. In Group A, IOL was done with transcervical foley’s catheter and vaginal misoprostol while in group B, mifepristone with vaginal misoprostol were used for IOL. During intrapartum period the mode of delivery, induction-delivery interval, total dose of induction agent used and amount of total blood loss were noted. Any side effect if present was also noted.

Results: Comparing both the groups, Induction delivery interval was less in group A as compared to group B.

Conclusions: Use of mifepristone with misoprostol as well as Foley’s with misoprostol were found to be equally safe and effective methods.

References

Lydon-Rochelle MT, Cárdenas V, Nelson JC, Holt VL, Gardella C, Easterling TR. Induction of labor in the absence of standard medical indications: incidence and correlates. Medical care. 2007:505-12.

World Health Organization. Seventy-first world health assembly global strategy for women’s, children’s and adolescents’ health (2016-2030): early childhood development status of women’s, children’s and adolescents’ health, 2018. Available at: http://www.geastudy.org/. Accessed 06 January 2023.

Centre for Reproductive Rights. Factsheet: the medical termination of pregnancy (amendment) act, 2021. Available at: https://reproductiverights.org/wp-content/uploads/2022/09/India-FACTSHEET-MTP-Amendment-Act-9-22.pdf. Accessed 05 January 2023.

Tai NN, Mulchandani R, Modi DA, Rami B. A prospective study of intrauterine death cases at a tertiary care hospital. Int J Reprod Contracept Obstet Gynecol. 2021;10(2):638.

FIGO. New FIGO Guidelines for Misoprostol Use, 2017. https://www.mhtf.org/2017/06/29/new-figo-guidelines-for-misoprostol-use. Accessed on 29 December 2022.

Hawker GA, Mian S, Kendzerska T, French M. Measures of adult pain: Visual analog scale for pain (vas pain), numeric rating scale for pain (nrs pain), mcgill pain questionnaire (mpq), short‐form mcgill pain questionnaire (sf‐mpq), chronic pain grade scale (cpgs), short form‐36 bodily pain scale (sf‐36 bps), and measure of intermittent and constant osteoarthritis pain (icoap). Arthr Car Res. 2011;63(S11):S240-52.

Athawale R, Acharya N, Samal S, Hariharan C. Effect of mifepristone in cervical ripening for induction of labour. Int J Reprod Contracept Obstet Gynecol. 2013;2(1):35-8.

Fonseca MN, Sah V. Comparative study between sequential use of Foley catheter with vaginal misoprostol versus sequential use of oral mifepristone with vaginal misoprostol for second trimester medical abortion. Inter J Reprod Contracep Obstet Gynecol. 2018;7(11):4545-51.

Bhathena RK, Sheriar NK, Walvekar VR, Guillebaud J. Second trimester pregnancy termination using extraamniotic ethacridine lactate. BJOG: An Inter J Obstet Gynaecol. 1990;97(11):1026-9.

Bebbington MW, Kent N, Lim K, Gagnon A, Delisle MF, Tessier F, et al. A randomized controlled trial comparing two protocols for the use of misoprostol in midtrimester pregnancy termination. Ame J Obstet Gynecol. 2002;187(4):853-7.

Panda S, Jha V, Singh S. Role of combination of mifepristone and misoprostol verses misoprostol alone in induction of labour in late intrauterin fetal death: A prospective study. J Fam Reprod Heal. 2013;7(4):177.

Väyrynen W, Heikinheimo O, Nuutila M. Misoprostol-only versus mifepristone plus misoprostol in induction of labor following intrauterine fetal death. Acta obstetricia et gynecologica Scandinavica. 2007;86(6):701-5.

Modak R, Roy S, Biswas DK, Pal A, Mandal TK. Role of combination of mifepristone and misoprostol versus misoprostol alone in induction of labor in late intrauterine fetal death: A randomized trial. Int J Clin Obstetr Gynaecol. 2018;2:78-82.

Rezk MA, Abo-Elnasr M, Al-Halaby A. Combined use of intracervical foley catheter and vaginal misoprostol for termination of second trimester pregnancy: Clinical Obst. Gyn and Reprod Med. 2015;1(3):79-83.

Ranjan S, Sarojini A, Mohapatra I, Vivekanand A, Ranjan S. Comparison of intravaginal misoprostol alone and in combination with intracervical Foley’s catheter for termination of second trimes-ter pregnancy-3 years study at a tertiary care hospital. Perspect Med Res. 2016;4:3-8.

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Published

2023-05-26

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Original Research Articles