Cross-sectional Study on Induction Methods for Third-trimester Stillbirths

Aim: To know the various induction methods used for 3rd trimester stillbirths, induction delivery interval, success of induction methods and mode of delivery.Materials and methods: Prospective observational study of pregnant women admitted with 3rd trimester stillbirths done from 1st of January 2022 to 31st of December 2022.Women of all parity of more than 28 weeks of pregnancy with Bishop's score of 6 were included.Women already in labor, intrapartum stillbirths and multiple gestation were excluded from the study.Induction methods included Misoprostol (PGE1) only, Dinoprostone (PGE2) only, Intracervical Foley's catheter (mechanical) only and a combination of these.Frequency of use of inducing agents, Induction delivery interval, mode of delivery and adverse events were noted.Results: 170 pregnant women were included in the study.Out of 170 women who underwent induction, vaginal delivery was achieved in 161 (94.8%) cases and 9 (5.2%) cases required cesarean delivery.93% of induced cases delivered within 24 hours.Induction delivery time was 10.5 hours with PGE2-only method and 12.8 hours with PGE1-only method.Combination methods were required more often in primigravida and at earlier gestational ages (less than 36 weeks). Conclusion:Early induction of 3rd trimester stillbirths is an acceptable option.Induction is associated with successful deliveries within 24 hours, with less morbidity.More data is required on standard induction protocols in this group of women for ideal stillbirth care.Clinical significance: Uniform induction protocols are lacking in 2nd and 3rd trimester stillbirth management.Women need to be counseled regarding expectant management vs induction based on high-risk factors and the success of induction.The current study will shed light on various induction methods used in 3rd trimester stillbirths at a high-risk referral center.