Comparative study on the efficacy of mifepristone versus mifepristone and misoprostol in the induction of labor in cases of intrauterine fetal demise

Sakshi Srivastava; Ruma Sarkar; Shivani Bhadkaria; Pratima Sharma

doi:10.18203/2320-1770.ijrcog20240464

Authors

Sakshi Srivastava Department of Obstetrics and Gynecology, Government Medical College and Super Facility Hospital, Chakrapanpur, Azamgarh, Uttar Pradesh, India
Ruma Sarkar Department of Obstetrics and Gynecology, Baba Raghav Das Medical College, Gorakhpur, Uttar Pradesh, India
Shivani Bhadkaria Department of Obstetrics and Gynecology, R. D. G. Medical College, Ujjain, Madhya Pradesh, India
Pratima Sharma Department of Obstetrics and Gynecology, Baba Raghav Das Medical College, Gorakhpur, Uttar Pradesh, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20240464

Keywords:

Bishop score, Gestational age, Intrauterine fetal demise, Labor induction, Mifepristone, Misoprostol

Abstract

Background: This study aimed to compare the efficacy of two labor induction methods, mifepristone alone and mifepristone followed by misoprostol, in cases of intrauterine fetal demise (IUFD) beyond 28 weeks of gestation.

Methods: A prospective study was carried out at, BRD Medical College in Gorakhpur and aimed to investigate the efficacy of two different methods for labor induction in pregnancies with intrauterine fetal demise (IUFD) beyond 28 weeks of gestation during September 2019 to August 2020. Sixty participants were divided into two groups of 30 each, with mifepristone administered orally in both groups. Group 2 received additional vaginal misoprostol. Patient demographics, Bishop scores, induction to active labor intervals, and induction to delivery intervals were examined. Augmentation methods, side effects, complications, and time to full dilatation were analyzed.

Results: The groups exhibited similar patient characteristics, including age, parity, socioeconomic status, and literacy rates. Gestational age at induction and Bishop scores were comparable. Both groups showed substantial improvements in Bishop scores. The induction to active labor interval was shorter in the mifepristone group, and the induction to delivery interval was similar. The mifepristone group required fewer mifepristone tablets, while the combination group used less misoprostol, reducing side effects. Complications were minimal, with a decreased need for augmentation methods in both groups.

Conclusions: Mifepristone, whether used alone or followed by misoprostol, proved effective in labor induction for IUFD beyond 28 weeks. Mifepristone's ability to enhance cervical ripening and prostaglandin sensitivity makes it a promising option for reducing the risks associated with delayed birth in cases of IUFD. These findings suggest that mifepristone can be a valuable addition to obstetric practices, particularly in cases where traditional induction methods may pose greater risks.

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