Termination of Pregnancy After Intrauterine Foetal Death

Keirse, Marc J. N. C.

doi:10.1007/978-94-009-7969-7_14

Cited by 3 publications

(9 citation statements)

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“…Traditional induction methods, such as amniotomy and oxytocin, are notoriously ineffective, particurlarly at low gestational ages as there is a 20-fold difference in oxytocin sensitivity between mid-pregnancy and term [ 3 , 4 ]. As reviewed by Keirse [ 5 ], before the advent of prostaglandins [ 6 ], inducing labor after early fetal death was frequently an ordeal for both the patient and her caregivers. Of the many treatments used, high doses of oxytocin were the most effective [ 7 ], but these nearly always led to some degree of water retention [ 8 ], often requiring the treatment to be spread over several days to avoid its consequences [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

A Randomized Controlled Trial of Misoprostol and Sulprostone to End Pregnancy after Fetal Death

Mensel¹,

Claerhout²,

Debois³

et al. 2009

Obstetrics and Gynecology International

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Objective. To compare effectiveness, side effects, and patients' perception of vaginal misoprostol versus intravenous sulprostone for ending pregnancy after fetal death between 14 and 42 weeks gestation. Method. Multicenter randomized controlled trial, using block randomization, central allocation, and prior power analysis. Outcome measures. Induction-delivery interval, gastrointestinal side effects, use of analgesia, pain perception, pyrexia, placental retention, hemorrhage, and women's opinions. Results. Of 176 women aimed for, 143 were randomized over 7 years, of whom 4 were excluded. There was no difference in delivery within 24 and 36 hours: 91.4% and 97.1% with misoprostol (n = 70) versus 85.5% and 92.8% with sulprostone (n = 69). There was no difference in either gastrointestinal side effects, as reported by the women and their caregivers, use of analgesia, women's pain perception, blood loss or placental retention. Hyperthermia ≥38°C was more common with misoprostol (24.3%) than with sulprostone (11.6%; difference: +12.7%; 95% CI: +1.2% to +25.3%) and related to the total dose used. Acceptability of both induction methods was similar except for freedom of movement, which was substantially in favor of misoprostol (lack of freedom reported with misoprostol in 34.3% versus 63.8% with sulprostone; difference: −29.5%; 95% CI: −13.6% to −45.4%). Conclusions. Misoprostol and sulprostone are similarly effective with little difference in side effects except for hyperthermia, related to the dose of misoprostol used, and women's reported lack of mobility with intravenous sulprostone. Effectiveness of both methods increased with gestational age.

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Section: Introductionmentioning

confidence: 99%

A Randomized Controlled Trial of Misoprostol and Sulprostone to End Pregnancy after Fetal Death

Mensel¹,

Claerhout²,

Debois³

et al. 2009

Obstetrics and Gynecology International

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“…Because of the rarity of antepartum fetal death, obstetricians have tended to adopt methods that had been shown to be efficacious for terminating second-trimester pregnancies (Keirse 1982). Some of these regimens are inappropriate and too few women derive benefit from the knowledge that induction of labour is more readily achieved after the fetus has died than when the fetus is alive (Luengo et al 1977;Karim et al 1979;Schulman et al 1979;Keirse 1982;Ratnam & Prasad 1986).…”

Section: Discussionmentioning

confidence: 99%

“…Unfortunately, the dosage commonly used and recommended by the manufacturer for inducing labour after fetal death (Rizk et al 1978;Schmidt-Gollwitzer et al 1979;Keirse & Lobatto 1983;Kanhai & Keirse 1986) relates to experience gained in tcrrninating second-trimester pregnancies with a live fetus. This applies to most prostaglandin regimens, but there is evidence that labour is more readily induced with prostaglandins when the fetus is dead than when it is alive (Karim et al 1979;Keirse 1982;Ratnam & Prasad 1986). Our experience (Kanhai & Keirse 1986) and that of others (Fawzy & Basiony 1979; Gruber & Baumgarten 1980) suggested that lower doses of sulprostone than those commonly used did not result in a significant loss of efficacy.…”

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confidence: 84%

“…of natural prostaglandins in the doses needed to achieve delivery in preterm gestations results in frequent side-effects (Southern et al 1978;Scher etal. 1980;Keirse 1982;Tindall& Reid 1989). In some countries this has led to an increasing reliance on local, mainly extra-amniotic, routes of administration (Embrey et al 1974;Scher et al 1980;Tindall & Reid 1989).…”

mentioning

confidence: 99%

“…In some countries this has led to an increasing reliance on local, mainly extra-amniotic, routes of administration (Embrey et al 1974;Scher et al 1980;Tindall & Reid 1989). In other countries, where prostaglandin analogues are available for systemic use, analogues have largely superseded the natural prostaglandins because of their enhanced efficacy and lower association with side-effects (Saarikoski et al 1980;Keirse 1982;Ratnam & Prasad 1986;Keirse & Kanhai 1989). This trend has occurred in the Netherlands, where two prostaglandin analogues, ,Upjohn) and 16-phenoxy-17,18.19,20tetranor-PGE2-methylsulphonamide (sulprostone; Nalador; Schering), are available for the induction of labour after antepartum fetal death (Wallenburg etal.…”

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confidence: 99%

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Induction of labour after fetal death: A randomized controlled trial of two prostaglandin regimens

Kanhai¹,

Keirse²

1990

Intl J Gynecology & Obste

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A total of 85 women with antepartum fetal death between 14 and 42 weeks gestation was randomly assigned to one of two regimens of intravenous infusion of the prostaglandin analogue 16-phenoxy-17, 18, 19, 20-tetranor-PGE2-methylsulphonamide (sulprostone) for inducing labour. Women received either 1 yglmin until delivery or the commonly recommended treatment of 1500 pg in 8 h followed by another, identical course of treatment if delivery did not occur within 24 h. The 1 pg/min dose schedule used half the amount of prostaglandin and resulted in statistically significantly fewer gastrointestinal side-effects compared with the conventional treatment. A11 women were delivered vaginally and there were no differences in induction-to-delivery intervals between the two treatments. Sulprostone infused at a rate of 1 pg/min resulted in a 50% chance of being delivered within 12 h and a 90% chance of being delivered within 24 h, with an overall frequency of sideeffects of 20%.

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Induction of labour after fetal death: a randomized controlled trial of two prostaglandin regimens

Kanhai

Keirse

1989

BJOG

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Summary A total of 85 women with antepartum fetal death between 14 and 42 weeks gestation was randomly assigned to one of two regimens of intravenous infusion of the prostaglandin analogue 16‐phenoxy‐17, 18, 19, 20‐tetranor‐PGE2‐methylsulphonamide (sulprostone) for inducing labour. Women received either 1 μg/min until delivery or the commonly recommended treatment of 1500 μg in 8 h followed by another, identical course of treatment if delivery did not occur within 24 h. The 1 μg/min dose schedule used half the amount of prostaglandin and resulted in statistically significantly fewer gastrointestinal side‐effects compared with the conventional treatment. All women were delivered vaginally and there were no differences in induction‐to‐delivery intervals between the two treatments. Sulprostone infused at a rate of 1 μg/min resulted in a 50% chance of being delivered within 12 h and a 90% chance of being delivered within 24 h, with an overall frequency of side‐effects of 20%.

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Termination of Pregnancy After Intrauterine Foetal Death

Cited by 3 publications

References 29 publications

A Randomized Controlled Trial of Misoprostol and Sulprostone to End Pregnancy after Fetal Death

A Randomized Controlled Trial of Misoprostol and Sulprostone to End Pregnancy after Fetal Death

Induction of labour after fetal death: A randomized controlled trial of two prostaglandin regimens

Induction of labour after fetal death: a randomized controlled trial of two prostaglandin regimens

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