Therapeutic termination of second trimester pregnancies with intrauterine fetal death with 400 micrograms of oral misoprostol


Saipin Pongsatha, M.D., Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand. Email:


Objective: To assess the efficacy and maternal side-effects of oral misoprostol for second trimester termination of pregnancies with intrauterine fetal death.

Methods: A prospective descriptive study was conducted on 63 pregnant women who had intrauterine fetal death with unfavorable cervix (Bishop scores ≤4). All received 400 µg of misoprostol orally every 4 h until favorable cervix was achieved. Main outcome measures included success rate of termination within 12, 24, 36 and 48 h, mean induction to delivery time and maternal side-effects.

Results: The success rates of termination within 12, 24, 36, 48 h were 50.8%, 84.1%, 88.9% and 92.1%, respectively. Mean induction to delivery time in cases of delivery within 48 h was 13.2 ± 8.4 h, range 2.25–22.9 h. The most common maternal side-effect was chill (33.3%). No serious maternal complication was detected.

Conclusion: 400 µg oral misoprostol every 4 h is effective for pregnancy termination in cases of intrauterine fetal death and may be an alternative regimen because of its ease and convenience.