O Ogbeiwi, N France, R Hardyal, B Hyman

O-37 Evaluating management strategies for late pregnancy loss: a randomized clinical trial at Georgetown Public Hospital Corporation (GPHC)

Author(s): O Ogbeiwi, N France, R Hardyal, B Hyman
Type Of Study:
  • Quantitative
Country(ies) Of Focus:
  • Guyana
Year of Presentation: 2026

Abstract

Objective: The combination of mifepristone and misoprostol has been shown to shorten induction-to-delivery times compared to misoprostol alone; however, limited data are available in our settings. This study aimed to compare the efficacy, safety, and tolerance of a mifepristone-misoprostol regimen versus misoprostol alone for inducing labor in third-trimester intra-uterine foetal death (IUFD) cases at the GPHC.

Methods: This Randomized controlled trial included women with confirmed third-trimester IUFD admitted to the Department of Obstetrics and Gynecology at GPHC between January 1 and December 31, 2023. Participants were randomly assigned to receive either oral mifepristone 200mg followed 24hours later by vaginal misoprostol, or vaginal misoprostol alone. Statistical analysis was performed using SPSS Version 29.0.1.1, and the results were expressed in percentages.

Results: The induction-to-delivery time was significantly shorter using the combination group compared to the misoprostol-only group (p=<0.0001). Secondary outcomes included need for additional doses, maternal complications, and patient satisfaction showed no significant difference. Safety, tolerance, analgesia requirements, and oxytocin use were comparable between groups. The combination regimen demonstrated better overall efficiency without increasing adverse events.

Conclusion: The combination of mifepristone and misoprostol is a more effective regimen for managing thirdtrimester IUFD, reducing induction time without compromising safety.

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