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The use of prostaglandin E2 vaginal suppositories is an effective method of uterine evacuation for patients with intrauterine fetal demise. Advanced extrauterine gestation, because of its rarity, is usually not a primary consideration for patients presenting with fetal death. This report presents 4 such cases and strongly suggests that, when this drug is used for the treatment of fetal death, failure to induce contractions and to effect uterine evacuation within a reasonable time should prompt the consideration of extrauterine pregnancy.
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