DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20220907

Efficacy of mifepristone in the management of fibroid

Priyanka R., Hiremath P. B., G. Sindhujha Sekar

Abstract


Background: Uterine fibroids are the most common benign tumors of the uterus. The incidence has been shown to be as high as 70–80 percent in studies using histologic and sonographic examinations. Majority of fibroids are asymptomatic and when symptomatic, patients present with menstrual disturbances, infertility, lump abdomen or pressure effects. The complications associated are severe anemia, hyaline or red degeneration, urinary retention, hydronephrosis secondary to obstructive uropathy and rarely sarcomatous changes. The treatment depends upon the size, symptoms, location and age of the patient. The aim and objective of this study is to evaluate the effectiveness of Mifepristone in symptomatic improvement and reduction of the size of fibroid.

Methods: The study was conducted in Sri Venkateswaraa Medical College Hospital and Research Centre (SVMCH and RC), Puducherry. This is a hospital based longitudinal study conducted in between December 2019 to June 2021 for a period of 18 months. 30 consecutive cases were studied based on inclusion criteria. All patients were treated with mifepristone 50 mg once weekly for 6 months. Analysis was performed by using statistical package for the social sciences (SPSS) version 23 software.

Results: In this study we observed there was a significant improvement in the hemoglobin (Hb) level, significant reduction in uterine volume, fibroid size and endometrial thickness after 6th month follow-up.

Conclusions: Mifepristone was able to significantly improve the patient outcome by reducing the amount of blood flow during menstruation and increasing the Hb levels and significantly reduce the size of myoma.


Keywords


Mifepristone, Uterine fibroids, Myoma

Full Text:

PDF

References


Marsh EE, Ekpo GE, Cardozo ER, Brocks M, Dune T, Cohen LS. Racial differences in fibroid prevalence and ultrasound findings in asymptomatic young women (18-30 years old): A pilot study. Fertil Steril. 2013;99:1951-7.

Stewart EA, Cookson CL, Gandolfo RA, Schulze-Rath R. Epidemiology of uterine fibroids: A systematic review. BJOG. 2017;124:1501-12.

Cardozo ER, Clark AD, Banks NK, Henne MB, Stegmann BJ, Segars JH. The estimated annual cost of uterine leiomyomata in the United States. Am J Obstet Gynecol. 2012;206:211.

Soliman AM, Yang H, Du EX, Kelkar SS, Winkel C. The direct and indirect costs of uterine fibroid tumors: A systematic review of the literature between 2000 and 2013. Am J Obstet Gynecol. 2015;213:141-60.

Moravek MB, Yin P, Ono M. Ovarian steroids, stem cells and uterine leiomyoma: Therapeutic implications. Hum Reprod Update. 2014;21:1-12.

Farris M, Bastianelli C, Rosato E, Brosens I, Benagiano G. Uterine fibroids: an update on current and emerging medical treatment options. Ther Clin Risk Manag. 2019;15:157-78.

Tropeano G, Amoroso S, Scambia G. Non-surgical management of uterine fibroids. Hum Reprod Update. 2008;14:259-74.

Shaikh N, Mehra R, Goel P, Kaur R. Mifepristone in Fibroids: Comparative Study of Safety and Efficacy of Biweekly Dosage Vs Daily Dosage Schedule. J Midlife Health. 2021;12(1):39-45.

Gupta JK, Sinha A, Lumsden MA. Uterine artery embolization for symptomatic uterine fibroids. Cochrane Database Syst Rev. 2014;12:CD005073.

Hirst A, Dutton S, Wu O. A multi-centre retrospective cohort study comparing the efficacy, safety and cost-effectiveness of hysterectomy and uterine artery embolisation for the treatment of symptomatic uterine fibroids. Health Technol Assess. 2008;12(5):1-248.

Das R, Sinha NK, Bagchi P, Acharya SK. Uterine Fibroids of Women of Reproductive Age Group: The Health and Ecological Analysis. International Conference on Public Health: Issues, challenges, opportunities, prevention, awareness. 2016.

Singh S, Pathak A, Yadav D, Jain P. Efficacy and Safety of Mifepristone vs Ulipristal Acetate in Medical Management of Fibroid- A Comparative Study. JMSCR. 2021;9(4):52-7.

Sathyanarayana Reddy S. Efficacy of low dose Mifepristone in the treatment of symptomatic uterine fibroids. JMSCR. 2020;8(7):480-3.

Arora D, Chawla J, Kochar SPS, Sharma JC. A randomized control trial to assess efficacy of Mifepristone in medical management of uterine fibroid. Med J Armed Forces India. 2017;73(3):267-73.

Mukherjee S, Chakraborty S. A study evaluating the effect of mifepristone (RU-486) for the treatment of leiomyomata uteri. Nigerian Med J Nigeria Med Assoc. 2011;52(3):150-2.

Kirsty M, Crithley HOD. Advances in the Management of uterine fibroids. F1000 Med Rep. 2009;1:74.

Charles H, Groenwald M. Comorbid medical conditions in women undergoing uterine artery embolization for symptomatic uterine fibroids and adenomyosis. J Vasc Intervent Radiol. 2013;24(4):S152.