Monday, June 6, 2011
Lawyer died after doctors gave 16 times correct dose of labour drug
NICE guidelines: Induction of Labor defines protocol of management :
1.2.9 Intrauterine fetal death
188.8.131.52 In the event of an intrauterine fetal death, healthcare professionals should offer support to help women and their partners and/or family cope with the emotional and physical consequences of the death. This should include offering information about specialist support.
184.108.40.206 In the event of an intrauterine fetal death, if the woman appears to be physically well, her membranes are intact and there is no evidence of infection or bleeding, she should be offered a choice of immediate induction of labour or expectant management.
220.127.116.11 In the event of an intrauterine fetal death, if there is evidence of ruptured membranes, infection or bleeding, immediate induction of labour is the preferred management option.
18.104.22.168 If a woman who has had an intrauterine fetal death chooses to proceed with induction of labour, oral mifepristone, followed by vaginal PGE2 or vaginal misoprostol, should be offered. The choice and dose of vaginal prostaglandin should take into account the clinical circumstances, availability of preparations and local protocol.
22.214.171.124 For women who have intrauterine fetal death and who have had a previous caesarean section, the risk of uterine rupture is increased. The dose of vaginal prostaglandin should be reduced accordingly, particularly in the third trimester.
Vaginal PGE2 has been used in
practice for many years in women with a history of previous caesarean section. However, the SPCs (July 2008) advise that the use of vaginal PGE2 is not recommended in women with a history of previous caesarean section. Informed consent on the use of vaginal PGE2 in this situation should therefore be obtained and documented. UK