Intrauterine foetal demise in pre-eclampsia - role of mifepristone: a case series

Abstract

Mifepristone is a steroid, which is a progesterone antagonist and is widely used for termination of pregnancies in all the trimester. It increases the sensitivity of the uterus to prostaglandins and ripens the cervix. Its role in inducing women with intra uterine demise is on the rise with varying dose regimen either alone or in combination with misoprostol. Among the various causes of intrauterine demise, one of the most important is hypertensive disorders of pregnancy complicating around 10% of pregnancies worldwide, Serum uric acid, a marker of oxidative stress is an important parameter in defining poor fetal outcome in women with pre-eclampsia. Induction of labour in women diagnosed with intrauterine demise is again a challenge in such women and mifepristone helps to a larger extent. In present case series, authors present six women presenting with pre-eclampsia with intrauterine demise, their clinical and biochemistry profile and responding to single dose of mifepristone of 200 mg with mean induction to delivery interval being 40 hours. Henceforth, authors conclude that even single dose of mifepristone can work wonders taking into consideration the cost of the drug and thus can be definitely employed in daily clinical practice.