The use of mifepristone and misoprostol in the management of late intrauterine fetal death

Key content A combination of mifepristone and misoprostol is the gold standard treatment for induction of labour in women with late intrauterine fetal death. This article attempts to review the current best available evidence as well as provide an insight based on the available evidence regarding the dosing regimens and safety in women with a previous caesarean section. Learning objectives To review the pharmacokinetics, mode of action, efficacy, adverse effects, dose and route of administration of mifepristone and misoprostol. To review the safety of misoprostol in women with previous caesarean section and other uterine scars. Ethical issues To identify the most effective regimen with the fewest adverse effects. To balance the desire to achieve a quick and successful induction with the risk of complications including uterine rupture in women with previous uterine scars. To provide a sympathetic approach to women who are already emotionally stressed.