ArticleInternational journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics2026
Prostaglandin dose and time to fetal expulsion after intrauterine fetal death at 22 to 28 gestational weeks in Sweden: A retrospective cohort study.
Article in International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- Efficacy of Vaginal Misoprostol for Labor Induction in Intrauterine Fetal Death: A Cohort Study from West Java Largest Hospital.International journal of women's health · 2026Article
- Prostaglandin dose and time to fetal expulsion after intrauterine fetal death at 22 to 28 gestational weeks in Sweden: A retrospective cohort study.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Article
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Abstract
objectiveProstaglandin regimens for induction of intrauterine fetal death (IUFD) <28 gestational weeks (GW) are unstandardized. We aimed to describe prostaglandin regimens for induction after IUFD and assess association between dose and time to fetal expulsion.
methodsWe performed a retrospective cohort study among all singleton IUFD 22-28 GW in the Stockholm region, Sweden, 2008-2015. The cumulative prostaglandin dose within 6 h was categorized as a low-, medium-, or high (equivalent to ≤200 μg, >200 μg but <800 μg, or ≥800 μg of misoprostol) based on variations in current clinical guidelines. Our primary outcome was time to fetal expulsion >12 h assessed using multinomial logistic regression adjusting for parity, age, gestational age, Bishop score and previous cesarean section.
resultsAmong 136 IUFD cases, 22 prostaglandin induction regimens were used. A total of 51 (77.3%) women in the low-dose group had an induction >12 h compared to 11 (30.6%) in the medium-, and 13 (42.4%) in the high, adjusted risk ratio (ARR) 1.91 (95% confidence interval [CI]: 1.43-2.23) between the high- and low-dose group. Median time to fetal expulsion was 21 h 11 min in the low- (P < 0.001), 10 h 21 min in the medium- (P = 0.90) and 10 h 12 min in the high-dose group.
conclusionIUFD cases <28 GW induced with doses equivalent to misoprostol ≤200 μg within 6 h on average had significantly longer time to fetal expulsion and were almost twice as likely to have an induction >12 h compared to higher doses. Women with IUFD at this gestation would likely benefit from higher prostaglandin doses than those recommended in clinical guidelines if safety is ascertained.
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