An ultrasound of a 7-month-pregnant client shows fetal death. Which medication is appropriate for evacuation of the uterus?

Dinoprostone is the appropriate medication for the evacuation of the uterus in the case of fetal death in utero. Dinoprostone is a prostaglandin E2 that facilitates cervical ripening and uterine contractions, making it effective for the expulsion of fetal tissue. It is commonly used in the management of pregnancy loss to help ensure that the uterus can empty completely and reduce the risk of complications such as infection or bleeding.

In contrast, misoprostol, while also a prostaglandin used for similar purposes, is typically indicated for medical termination of pregnancy or cervical ripening but may not be the first choice in the specific scenario of fetal demise and evacuation, depending on clinical guidelines and the provider’s protocol. Oxytocin, which stimulates uterine contractions, is primarily used during labor rather than for evacuation after fetal demise. Rho(D) immune globulin is used to prevent Rh sensitization in Rh-negative mothers and does not have a role in managing the evacuation of the uterus after a fetal death. This further highlights why dinoprostone is the most suitable option for this situation.