{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T02:28:16Z","timestamp":1781144896092,"version":"3.54.1"},"reference-count":15,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2022,10,3]],"date-time":"2022-10-03T00:00:00Z","timestamp":1664755200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002842","name":"Chiang Mai University Research Fund","doi-asserted-by":"publisher","award":["CMU-2566"],"award-info":[{"award-number":["CMU-2566"]}],"id":[{"id":"10.13039\/501100002842","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Objective: To determine the efficacy and adverse outcomes of misoprostol with various regimens for the second-trimester-pregnancy termination of a dead fetus in utero (DFIU). Patients and Methods: A retrospective descriptive study, based on the prospective database, was conducted on pregnancies with dead fetuses in utero in the second trimester. All patients underwent pregnancy termination with various regimens of misoprostol. Results: A total of 199 pregnancies meeting the inclusion criteria were included. The mean age of the participants and the mean gestational age were 30.2 years and 21.1 weeks, respectively. The two most common regimens were 400 mcg injected intravaginally every six hours and 400 mcg taken orally every four hours. In the analysis of the overall efficacy, including all regimens, the mean fetal delivery time was 18.9 h. When considering only the cases involving a delivery within 48 h (success cases), the mean fetal delivery time was 13.6 h. The rates of fetal delivery for all cases at 12, 24, 36, and 48 h were 50.3%, 83.8%, 89.3%, and 93.9%. In the comparison between the various regimens, there were no significant differences in the rate of fetal delivery at 12, 24, 36, and 48 h and adverse effects such as chill, diarrhea, nausea, vomiting, and other parameters such as the requirement for intravenous analgesia, the requirement for curettage for incomplete abortions, the mean total dose of misoprostol, and the rate of postpartum hemorrhage (PPH). Nevertheless, the rate of fever was significantly higher in the regimen of intravaginal insertion of 400 mcg every six hours and that of the requirement for oxytocin was significantly higher in the regimen of oral supplementation of 400 mcg every four hours. Conclusions: The overall success rate within 48 h was 93.6%, which was not different among the various misoprostol regimens. In addition, there were no significant differences in the mean fetal delivery times and the rates of fetal delivery at 12, 24, 36, and 48 h. However, some parameters such as fever, oxytocin requirement, and mean total dose of misoprostol were statistically significant between regimens. In the aspect of global health, misoprostol can be a good option in clinical practice, especially in geographical areas with low-resource levels.<\/jats:p>","DOI":"10.3390\/ijerph191912655","type":"journal-article","created":{"date-parts":[[2022,10,8]],"date-time":"2022-10-08T22:19:27Z","timestamp":1665267567000},"page":"12655","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Outcomes of Pregnancy Termination of Dead Fetus in Utero in Second Trimester by Misoprostol with Various Regimens"],"prefix":"10.3390","volume":"19","author":[{"given":"Saipin","family":"Pongsatha","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nuchanart","family":"Suntornlimsiri","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3389-6478","authenticated-orcid":false,"given":"Theera","family":"Tongsong","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,10,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1016\/j.tjog.2013.10.016","article-title":"Analysis of intrauterine fetal demise\u2014A hospital-based study in Taiwan over a decade","volume":"52","author":"Liu","year":"2013","journal-title":"Taiwan J. Obstet. Gynecol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1002\/uog.16021","article-title":"Stillbirth and intrauterine fetal death: Contemporary demographic features of >1000 cases from an urban population","volume":"48","author":"Man","year":"2016","journal-title":"Ultrasound Obstet. Gynecol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.gyobfe.2014.11.008","article-title":"Fetal death beyond 14 weeks of gestation: Induction of labor and obtaining of uterine vacuity","volume":"43","author":"Beucher","year":"2015","journal-title":"Gynecol. Obstet. Fertil."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1016\/j.jgyn.2013.11.008","article-title":"Use of misoprostol for induction of labor in case of fetal death or termination of pregnancy during second or third trimester of pregnancy: Efficiency, dosage, route of administration, side effects, use in case of uterine scar","volume":"43","author":"Clouqueur","year":"2014","journal-title":"J. Gynecol. Obstet. Biol. Reprod."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1111\/jog.12147","article-title":"Randomized controlled trial comparing efficacy between a vaginal misoprostol loading and non-loading dose regimen for second-trimester pregnancy termination","volume":"40","author":"Pongsatha","year":"2014","journal-title":"J. Obstet. Gynaecol. Res."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1111\/j.1447-0756.2004.00184.x","article-title":"Therapeutic termination of second trimester pregnancies with intrauterine fetal death with 400 micrograms of oral misoprostol","volume":"30","author":"Pongsatha","year":"2004","journal-title":"J. Obstet. Gynaecol. Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1111\/jog.12910","article-title":"Vaginal misoprostol versus intravenous oxytocin for the management of second-trimester pregnancies with intrauterine fetal death: A randomized clinical trial","volume":"42","author":"Abediasl","year":"2016","journal-title":"J. Obstet. Gynaecol. Res."},{"key":"ref_8","first-page":"55","article-title":"A comparative study of vaginal misoprostol and intravenous oxytocin for induction of labour in women with intra uterine fetal death in Mulago Hospital, Uganda","volume":"1","author":"Nakintu","year":"2001","journal-title":"Afr. Health Sci."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1016\/j.contraception.2008.10.009","article-title":"Misoprostol for termination of pregnancy with intrauterine fetal demise in the second and third trimester of pregnancy\u2014A systematic review","volume":"79","author":"Wing","year":"2009","journal-title":"Contraception"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1097\/AOG.0b013e318227214e","article-title":"Mifepristone and misoprostol compared with misoprostol alone for second-trimester abortion: A randomized controlled trial","volume":"118","author":"Ngoc","year":"2011","journal-title":"Obstet. Gynecol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1111\/j.1479-828X.2006.00646.x","article-title":"Mifepristone- and misoprostol-induced mid-trimester termination of pregnancy: A review of 272 cases","volume":"46","author":"Rose","year":"2006","journal-title":"Aust. N. Z. J. Obstet. Gynaecol."},{"key":"ref_12","first-page":"642","article-title":"Methods of second trimester pregnancy termination and evacuation of in utero dead fetuses. Value of mifepristone","volume":"23","author":"Maria","year":"1994","journal-title":"J. Gynecol. Obstet. Biol. Reprod."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/j.1447-0756.1998.tb00044.x","article-title":"Efficacy of intracervicovaginal misoprostol in second-trimester pregnancy termination: A comparison between live and dead fetuses","volume":"24","author":"Srisomboon","year":"1998","journal-title":"J. Obstet. Gynaecol. Res."},{"key":"ref_14","first-page":"Cd002253","article-title":"Medical treatment for early fetal death (less than 24 weeks)","volume":"6","author":"Lemmers","year":"2019","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1016\/j.ijgo.2004.07.022","article-title":"Intravaginal misoprostol for pregnancy termination","volume":"87","author":"Pongsatha","year":"2004","journal-title":"Int. J. Gynaecol. Obstet."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/19\/12655\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:46:00Z","timestamp":1760143560000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/19\/12655"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,3]]},"references-count":15,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2022,10]]}},"alternative-id":["ijerph191912655"],"URL":"https:\/\/doi.org\/10.3390\/ijerph191912655","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,3]]}}}