Extra-amniotic prostaglandin induction of labour supplemented with intravenous oxytocin following fetal death in utero.

A five year retrospective study (1984-1989) was undertaken on 24 consecutive patients with fetal death to ascertain the efficacy, side effects and complications associated with a combination of extra-amniotic prostaglandin E and intravenous oxytocin to induce labour. Six patients with primigravidae and eighteen multigravidae with inductions carried out at gestations ranging from 16 to 37 weeks (mean 26 weeks and 3 days). The estimated time from fetal death to induction ranged from 1 day to 3 weeks (mean 8 days). Induction was successful in all cases with a mean induction to delivery time of 9 hours and 30 minutes. The mean dose of prostaglandin required was 0.914 gms and of oxotocin 12.78 I.U.s. Minor side effects were experienced by 16% of patients though none were serious. This series confirms the combination of extra-amniotic prostaglandin and intravenous oxytocin as an effective means of inducing labour where fetal death has occurred.