Role of mifepristone in preinduction cervical ripening and induction of labour at term: an observational study
Keywords:Bishop score, Induction of labour, Mifepristone
Background: Induction implies stimulation of uterine contractions before spontaneous onset of labour. It is indicated when the benefits to either mother or fetus outweigh those of pregnancy continuation. Of the various medical methods of induction, prostaglandins and oxytocin remain the most popular and acceptable methods in obstetric practice. Mifepristone is a steroid compound, with anti-progesterone activity. It increases uterine activity and causes cervical dilatation and effacement. We intend to study the role of oral mifepristone in preinduction cervical ripening and induction of labour in term pregnancies.
Methods: In a prospective observational study carried out from Jan 2023 to June 2023 at a zonal hospital, 100 antenatal women at term with Bishop score less than 6 participated. Tablet mifepristone 200 mg single dose was given orally for induction. All patients were assessed after 24 hours for cervical ripening, need for augmentation, mode of delivery, maternal and neonatal outcome.
Results: It was observed that there was a significant improvement in Bishop score 24 hours after giving mifepristone. Out of 100 women in the study, 82% delivered vaginally, 15% had caesarean section and 3% had instrumental delivery. 21% needed no second method of labour induction. 76% patients delivered within 48 hrs of ingestion of mifepristone. The majority of patients had good maternal and neonatal outcome.
Conclusions: Mifepristone is an effective and safe method for preinduction cervical ripening and induction of labour in term pregnancies.
Kumar A, Deepika N. Mifepristone for cervical ripening and induction of labour. Int J Obst Gynae Res. 2018;5(1):15-9.
Tenose JL. Methods for cervical ripening and induction of labour. Am Fam Physician. 2003;67:2123-8.
Gupta JK, Johnson N. Effect of mifepristone on dilatation of the pregnant and non pregnant cervix. Lancet. 1990;335(8700):1238-40.
Dharani H, James PN. Mifepristone for induction of labour (review). Cochrane Database Syst Rev. 2009;3.
Teutsch G. RU 486 development. Science. 1989;246(4933):985.
Yelikar K, Deshpande S, Deshpande R, Lone D. Safety and efficacy of oral mifepristone in preinduction cervical ripening and induction of labour in prolonged pregnancy. J Obstet Gynaecol India. 2015;65(4):221-5.
Priyanka, Shetty SS. The effect of mifepristone in induction of labour at term. MedPulse Inter J Gynaecol. 2021;17(2):32-5.
Athawale R, Acharya N, Samal S. Effect of Mifepristone in cervical ripening for induction of labour. Int J Reprod Contracept Obstet Gynaecol. 2013;2(1):35-8.
Vellanki J, Harmain Z, Limmala RK. Is mifepristone a game changer in induction of labour.. ? Int J Obst Gynae Res. 2023;10(2):115-18.
Fathima S, Nayak SR, Rao B, Gandhi P,Shameem VPA. Mifepristone in induction of labour at term. Int J Pharmac Biomedi Res. 2013;4(3):164-6.
Wing DA, Fassett Michael J, Mishell Daniel R. Mifepristone for preinduction cervical ripening beyond 41 weeks gestation: a randomised controlled trial. Obstet Gynaecol. 2000;96:543-8.
Jain M, Kaushal R. Clinical utility of mifepristone over oxytocin in preventing adversities of parturition outcomes: a comparative study. Int J Reprod Contracept Obstet Gynaecol. 2018;7(12):4808-13.