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18 wk fetal demise, cytotec (misoprostol) dosingFrom: Tim and Jude Kurokawa (jkuro@midrivers.com)Sat Aug 9 11:16:40 1997
UI - 94337842 AU - Bugalho A AU - Bique C AU - Machungo F AU - Faaundes A TI - Induction of labor with intravaginal misoprostol in intrauterine fetal death. AD - Department of Gynecology and Obstetrics, Maputo Central Hospital, Brazil. AB - OBJECTIVE: Our purpose was to evaluate the effectiveness and safety of intravaginal misoprostol for the induction of labor in intrauterine fetal death. STUDY DESIGN: Seventy-two women at 18 to 40 weeks of pregnancy with intrauterine fetal death, without abdominal scars, were treated with 100 micrograms of intravaginal misoprostol. The dose was repeated every 12 hours until effective uterine contractions and cervical dilatation were obtained, for up to 48 hours. RESULTS: The mean time from induction to delivery was 12.6 hours, and only six patients (8%) required between 24 and 48 hours, at the end of which all patients had been delivered. Only the Bishop's score was significantly associated with time from first dose to expulsion. No surgical procedure was required. Hypercontractility, sweating, fever, diarrhea, or other gastrointestinal effects were not detected. There was no need for analgesics. CONCLUSIONS: Intravaginal misoprostol at the dose of 100 micrograms every 12 hours appears to be a safe, effective, practical, and inexpensive new method for induction of labor in intrauterine fetal death. SO - Am J Obstet Gynecol 1994 Aug;171(2):538-41 \\\\\\\\\\\\\\\\\\\\\\\\\ Here is another but addresses term fetal demise: \\\\\\\\\\\\\\\\\\\\\\\\\\ 8 UI - 95208458 AU - Bugalho A AU - Bique C AU - Machungo F AU - Bergstrom S TI - Vaginal misoprostol as an alternative to oxytocin for induction of labor in women with late fetal death. AD - Department of Obstetrics and Gynaecology, Central Hospital, Maputo, Mozambique. AB - BACKGROUND. Induction of labor in women with late fetal death is often difficult in settings with scarce resources. The purpose of this study was to assess the value of vaginal misoprostol for induction of labor in women with such fetal death. METHODS. In Maputo 156 women with late fetal death were allotted in a non-randomised way to either vaginal misoprostol or intravenous infusion of oxytocin. Treatment outcomes were compared as to cost-effectiveness and safety. In the misoprostol group none received more than 800 micrograms. Oxytocin infusion followed an established routine. Statistical analyses were performed by EPI Info software. RESULTS. In cases with Bishop's score < 6 the induction-to-delivery interval averaged 14.8 hours in the misoprostol group and 31.0 hours in the oxytocin group (p 0.001). The corresponding values for women with Bishop's score > or = 6 were 6.6 and 8.7 hours, respectively (p = 0.4). Women with intact membranes had an induction-to-delivery interval of 13.8 hours in the misoprostol group and 26.9 hours in the oxytocin group (p = 0.002). The corresponding values in women with ruptured membranes were 7.8 and 10.5 hours, respectively (p 0.6). Successful induction was achieved in 81% of misoprostol-treated women at a dose of 100 micrograms or less. CONCLUSIONS. Vaginal misoprostol is a safe, low-cost drug particularly suitable in women of high average parity having late, fetal death. SO - Acta Obstet Gynecol Scand 1995 Mar;74(3):194-8 Jude Kurokawa, CNM Wolf Point, MT A Coyote midwife sits by the hole and waits.... Only Cowards cook on low.
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