Misoprostol use under routine conditions for termination of pregnancies with intrauterine fetal death

作者:do Nascimento Maria Isabel*; Cunha Alfredo de Almeida; dos Santos Muri Oliveira Sandra Regina; Nunes Glaucimara Gonzaga; Alvarez Felipe Silva; Villas Boas Eduardo Loyola
来源:Revista da Associacao Medica Brasileira, 2013, 59(4): 354-359.
DOI:10.1016/j.ramb.2013.02.005

摘要

Objective: To analyze the misoprostol use in pregnancies with intrauterine fetal death (IUFD), considering mode of delivery and induction-delivery interval. Methods: Descriptive study including 171 pregnant women with IUFD, in the second or third trimester, submitted to labor induction with vaginal misoprostol and/or induction/augmentation with intravenous oxytocin, from 2005 to 2008, at a teaching-hospital of the Brazilian Unified Health System (Sistema Unico de Saude - SUS). Results: Misoprostol alone (treatment A), misoprostol plus oxytocin (treatment B), and oxytocin alone (treatment C) were administered in 9.3%, 19.9%, and 70.8% of the cases, respectively. One-third of pregnancies were less than 28 weeks, and 2.9% required a caesarean section. The percentage of vaginal delivery in treatments A and B combined (98.0%) was similar to treatment C (96.7%). The mean induction-delivery interval was 15.4 hours. Comparing multiple groups, the mean induction-delivery interval was significantly shorter in treatment A (20.1 hours) than in treatment B (33.3 hours), and was longer than in treatment C (9.7 hours). The majority (71%) of cases required a single administration of misoprostol, and the total dosage was lower in treatment A (mean: 98.4 mu g) compared with treatment B (mean: 157.0 mu g). Conclusion: Misoprostol effectively contributed to delivery of IUFD by vaginal route assisted under routine conditions of a public health service in Brazil, demonstrating its importance in cases resistant to usual induction methods, and its availability in Brazilian public health services is recommended.

  • 出版日期2013-8

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