Dating of the intrauterine fetal demise
The use of misoprostol orally, sublingually or vaginally for the induction of labour in IUFD is off-label.
Intrauterine fetal death (IUFD) is defined by the full NICE guideline on the induction of labour and the RCOG guideline on late intrauterine fetal death and stillbirth as fetal death at 24 weeks gestation or later.
Particular problems related to delayed labour may arise, such as intrauterine infection if the membranes are ruptured, and a time-related risk of disseminated intravascular coagulopathy, which has been reported in 25% of women who retain a dead fetus for more than 4 weeks.
The management of induction of labour in women with late IUFD and a favourable cervix is often uncomplicated.
For women who choose to proceed with induction of labour, the guideline recommends that oral mifepristone followed by vaginal prostaglandin E) should be offered.
The choice and dose of vaginal prostaglandin should take into account the clinical circumstances, availability of preparations and local protocol.
Miso One (Exelgyn) contains 400 micrograms of misoprostol for oral administration.
In January 2013 it was licensed in the UK for the termination of intrauterine pregnancy, in sequential use with mifepristone, up to 49 days of amenorrhea.
analogue that softens the cervix and can stimulate uterine contractions.Medabon (Sun Pharmaceutical Industries Europe) is a combination pack containing 1 oral mifepristone 200 mg tablet and 4 vaginal misoprostol 200 microgram tablets.It received UK marketing authorisation in May 2012 for the termination of intrauterine pregnancy of up to 63 days of amenorrhoea.Talk with your doctor and family members or friends about deciding to join a study. Bolnick JM, Velazquez MD, Gonzalez JL, Rappaport VJ, Mc Ilwain-Dunivan G, Rayburn WF. Arteaga-Troncoso G, Villegas-Alvarado A, Belmont-Gomez A, Martinez-Herrera FJ, Villagrana-Zesati R, Guerra-Infante F. Ignarro LJ, Lippton H, Edwards JC, Baricos WH, Hyman AL, Kadowitz PJ, Gruetter CA. Espey MG, Miranda KM, Feelisch M, Fukuto J, Grisham MB, Vitek MP, Wink DA. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. Randomized trial between two active labor management protocols in the presence of an unfavorable cervix. Intracervical application of the nitric oxide donor isosorbide dinitrate for induction of cervical ripening: a randomised controlled trial to determine clinical efficacy and safety prior to first trimester surgical evacuation of retained products of conception. Mechanism of vascular smooth muscle relaxation by organic nitrates, nitrites, nitroprusside and nitric oxide: evidence for the involvement of S-nitrosothiols as active intermediates. Mechanisms of cell death governed by the balance between nitrosative and oxidative stress.