“Medical Induction for Intrauterine Fetal Death (IUFD) in a Tertiary Care Hospital”

Introduction: Intrauterine fetal death (IUFD) is a sad event for both mothers and medical personnel. In the developing world, IUFD is calculated based on deaths at 28 or more weeks of gestation or weight of 1000 gms or more. Traditionally, early nonviable pregnancies (less than 14 weeks) have been terminated by surgical evacuation and later pregnancies (14 weeks onwards) have been ended by medical induction. In this study, we aimed to evaluate the outcome of medical induction for IUFD in a tertiary care hospital. Methods: This was a prospective observational study and was conducted in the Department of Obstetrics & Gynecology, Holy Family Red Crescent Medical College Hospital, Dhaka, Bangladesh during the period from January 2019 to December 2020. In our study, we included 20 pregnant women with IUFD who attended the department of obstetrics & gynecology. Result: The mean age of our patients was 27.25±4.47 years. The majority of patients had 2nd gravida (45%), and most of our patients (45%) were 28-32 weeks pregnant. Among all our diagnosis findings, we found that the majority of patients (50%) had a previous history of IUFD, followed by severe preeclampsia (35%) and pregnancy-induced hypertension (20%). Among all patients, Mifepristone was taken by 100%, followed by Misoprostol was taken by 90%. The majority (40%) of patients were successful in IUFD after the combination of Mifepristone and 2nd dose of Misoprostol. Conclusion: Our study findings showed that the combination of mifepristone with misoprostol was more effective than misoprostol or mifepristone alone for the induction of labor in IUFD, in terms of a higher rate of successful delivery.