Abstract

Background: Intrauterine fetal death (IUFD) i.e. the death of a fetus in utero after 22 weeks gestation is a remarkable gyanecological problem worldwide - incidence of intrauterine fetal death (IUFD) is high enough – about 1.89% of live births round the world. And, aim of this study was to have a look into the outcome of intrauterine Foley’s catheter balloon with or without vaginal misoprostol in cervical ripening and induction of labour in pregnant women with IUFD.
Methods: This cross-sectional hospital-based study was carried out at the Department of Obstetrics and Gynaecology of 250 Bedded Mohammad Ali Hospital, Bogura from July 2024 to December 2024.   Cases were selected by purposive sampling technique (N=40). A self- retained Foleys catheter was introduced and the balloon was inflated with water. In addition to Foley’s catheter, misoprostol was used in the posterior fornix in 27 cases randomly. Then we waited for completion of the procedure. In incomplete expulsions, we proceeded for D&C and in cases unresponsive by 48 hours, we proceeded for hysterotomy or LSCS. Data was compiled as actual number, percentage of total or Mean±SD (as applicable). Chi-squire test, Student’s ‘t’ test (unpaired) and Odd’s ratio were used to assess the level of significance. 
Result: Age range was 18 to 36 years with mean±SD of age being 26.4 ± 5.95 years. Complete evacuation was achieved in 27 of all the cases (N=40) of both the groups and the remaining 13 cases were either with retained product of conception or totally unresponsive, required D&C or hysterotomy or Cesarean section. The difference in result observed in two different procedures (i.e., with or without misoprostol) was insignificant (χ2 = 0.31, P>0.10); but Odd’s ratio was (1.484) weakly in favor of Combined ICC plus Misoprostol application. Mean ± SD of age of those where any of the trials was successful was 25.33±5.73 years and of the trial-failed cases was 28.61±5.95 years; (t=1.65, P>0.10). Among all the cases 16 were primigravida and 24 were multigravida. Balloon inflation procedure failed in 25% of the primigravida but in 38% of multigravida (χ2=0.034, P>0.10; Odd’s Ratio=1.80). No difference of gestational age was found failed and success cases.
Conclusion: In the management of uncomplicated IUFD, intracervical Foley’s catheter, with or without vaginal misoprostol, may be a good method for hospitalized cases – of course the sample size is too small to draw a conclusion clearly or definitely.
 

Keywords

1. INTRODUCTION