• Niger J Clin Pract · Feb 2024

    Randomized Controlled Trial

    A Comparison of the Efficacy and Safety of Mifepristone and Misoprostol Versus Misoprostol alone for Induction of Labour in Nigerian Women with Intrauterine Fetal Death: A Triple Blind Randomized Controlled Trial.

    • A Ekoh, P N Ebeigbe, and C Mofon.
    • Department of Obstetrics and Gynaecology, Delta State University Teaching Hospital, Oghara, Delta State, Nigeria.
    • Niger J Clin Pract. 2024 Feb 1; 27 (2): 159166159-166.

    BackgroundIntrauterine foetal death (IUFD) is an unpleasant pregnancy outcome and prompt delivery of the dead foetus is usually desired by mothers. Unfortunately, spontaneous labour and delivery may not occur early and prolonged retention of the dead foetus in utero is life-threatening. Many of the agents currently used for the induction of labour may result in a prolonged delivery process.ObjectivesTo compare the efficacy and safety of mifepristone and misoprostol versus misoprostol alone for induction of labour in women with intrauterine foetal death.Materials And MethodsThis was a triple-blind randomized controlled trial. Eighty women were randomized into two groups. The intervention group received a single oral dose of 200 mg mifepristone, followed by 6-hourly 50 μg misoprostol vaginal insertion, after 24-hour intervals. The control group received a placebo, followed by 6-hourly 50 μg misoprostol vaginal insertion, after 24-hour intervals. The primary outcome measure was the induction to delivery interval.ResultsMaternal age, gestational age, parity and pre-induction bishop's score were comparable between the two groups. The mean induction to the delivery interval in the intervention group was significantly less in the intervention group than the control group (18.78 ± 6.51 hours versus 37.10 ± 10.10; P < 0.001). The total dose of misoprostol required for induction of labour; the need for oxytocin augmentation of labour; and the observed side effects of misoprostol were all significantly less in intervention group than control group (P < 0.001; P < 0.01; and P = 0.03, respectively).ConclusionThe combination of mifepristone and misoprostol has greater efficacy and better safety profile than the use of misoprostol alone for induction of labour. This combination should be considered when induction of labour is indicated for IUFD.Copyright © 2024 Copyright: © 2024 Nigerian Journal of Clinical Practice.

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