The use of gemeprost for induction of labour after intrauterine death in the third trimester

Summary

A retrospective review of induction of labour after singleton fetal death in the third trimester was carried out. third particular interest in the use, efficacy and incidence of side—effects of 16,16-dimethyl-trans-D2 prostaglandin El methyl ester, Gemeprost. In the 147 cases studied. gemeprost was the commonest induction agent used (43 women) with prostin E: vaginal gel the next most common (35 women). The efficacy of gemeprost was slightly less than prostin (88.3 per cent versus 91.4 per cent successful induction) but gemeprost had a significantly shorter induction to delivery time. It was also less invasive requiring artificial rupture of membranes and syntocinon significantly less often. There were three ruptured uteri, one each in the gemeprost and prostin groups and one out of the 40 spontaneously labouring women. This suggests that monitoring of uterine contractions is important despite the demise of the fetus, that cervical preparation with mifepristone should be considered and that the second trimester dose of gemeprost may be too high for third trimester induction.