Induction of labor with intravaginal misoprostol in intrauterine fetal death

Vaginally applied misoprostol (RU 486) may be an effective and safe drug for inducing labor in women whose fetuses have died. Misoprostol is a prostaglandin E2 analog used orally for abortion. Seventy-two women delivered at a Mozambique hospital had misoprostol labor induction for fetal death at gestational ages 18 to 40 weeks. No woman had a uterine scar. The mean length of time from induction to birth was 12.6 hours. Ninety-two percent delivered by 24 hours and all women delivered by 48 hours. No adverse effects were noted and no surgical procedures were required. Moreover, misoprostol costs much less than other alternatives and unlike an oxytocin drip, it does not require continuous supervision.