SIMPLIFIED INDUCTION OF LABOUR FOR THE PATIENT WITH A DEAD BABY IN UTERO.

The problem posed by the presence of a dead fetus in utero after the first trimester is important because of the psychological attitude of the patient and the danger of hypofibrinogenemia. In the past, induction of labour in these patients has often been difficult, and surgery has had to be undertaken to empty the uterus.In these patients, labour was induced by inserting a needle with a trocar through the abdominal wall under local anesthesia into the amniotic sac. Approximately 200 ml. of amniotic fluid is withdrawn and replaced with a slightly larger amount of 20% saline solution. Labour began within 24 hours and delivery occurred within the next 14 hours. There have been no complications or failures with this technique in the cases reported in the literature.