Objective: To determine the safety and effectiveness of managing intrauterine death after 24 weeks gestation using a combination of mifepristone and misoprost ol. Study design: Two regimens are compared. Twenty-nine women (group one)-wer e managed using a combination of oral mifepristone and vaginal/oral misoprostol. After a change in dosage and route of administration, a further 20 women were m anaged with oral mifepristone and vaginal misoprostol (group two). Results: All women delivered vaginally. The mean induction to delivery interval in group one was 7 h compared with 10.2 h in group two. Group two experienced fewer gastroint estinal side-effects than group one. Conclusion: This study confirms that the c ombined use of mifepristone and misoprostol is a safe and effective way of manag ing IUD after 24 weeks gestation. Regimen one results in a shorter induction to delivery interval but is associated with a higher incidence of gastrointestinal side-effects. Objective: To determine the safety and effectiveness of managing intrauterine death after 24 weeks gestation using a combination of mifepristone and misoprost ol. Study design: Two regimens are compared. Twenty-nine women (group one) -wer e managed using a combination of oral After a change in dosage and route of administration, a further 20 women were m anaged with oral mifepristone and vaginal misoprostol (group two). Results: All women delivered vaginally. The mean induction to delivery interval in group one was 7 h compared with 10.2 h in group two. Group two experienced fewer gastroint estinal side-effects than group one. Conclusion: This study confirms that the c ombined use of mifepristone and misoprostol is a safe and effective way of manag ing IUD after 24 weeks gestation. Regimen one results in a shorter induction to delivery interval but is associated with a higher incidence of gastrointestinal side-effects.