DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20184690

Clinical utility of mifepristone over oxytocin in preventing adversities of parturition outcomes: a comparative study

Mudita Jain, Rituja Kaushal

Abstract


Background: Of the various medical methods of induction, induction with oxytocin and prostaglandins remain the most popular and acceptable methods in modern obstetric practice. The present cross-sectional study conducted in the Department of Obstetrics and Gynecology, Kamla Raja Hospital, Gwalior, mifepristone has been used through oral route for induction of labor. The objectives of the present study were to evaluate the effect of oral mifepristone for induction of labor, to record the outcome of labor and the incidence of operative interference, and to see any adverse effects on mother and/or neonate with its use, to compare its effect with other medical method of labor induction.

Methods: The present study is a prospective comparative study carried out in the Department of Obstetrics and Gynecology, G. R. Medical College and Kamla Raja Hospital, Gwalior (M.P.), from May 2009 to June 2010. Total number of patients involved in the study is 119, study group comprised of 69 patients in which oral mifepristone (200mg) was given on day 1 and day 2 of a four-day observation period. The control group comprised of 50 patients induced with intravenous oxytocin group.

Results: On overall assessment of the efficacy of labour induction with oral mifepristone as compared to intravenous (I/V) oxytocin, we found that there was no significant difference in the mode of delivery (vaginal and caesarean section) and Apgar score.

Conclusions: The induction of active labour induction, induction to delivery interval is higher in mifepristone group as compared to oxytocin group. However, the drug resulted in higher rates of vaginal birth after cesarean section (VBAC) with no grave maternal and fetal outcomes, so thus aspect of oral mifepristone is of great consideration and requires further research.


Keywords


Comparative study, Delivery outcome, Mifepristone, Oxytocin, Tertiary care centre

Full Text:

PDF

References


Lelaidier C, Baton C, Benifla JL, Fernandez H, Bourget P, Frydman R. Mifepristone for labour induction after previous caesarean section. Randomized controlled trial. Br J Obstet Gynaecol. 1994;101(6):501-3.

Giacalone PL, Targosz V, Laffargue F, Boog G, Faure JM. Cervical ripening with mifepristone before labor induction: a randomized study. Randomized controlled trial. Obstet Gynecol. 1998;92(4 Pt 1):487-92.

Elliott CL, Brennand JE, Calder AA. The effects of mifepristone on cervical ripening and labor induction in primigravidae. Randomized controlled trial. Obstet Gynecol. 1998;92(5):804-9.

Stenlund PM, Ekman G, Aedo AR, Bygdeman M. Induction of labor with mifepristone--a randomized, double-blind study versus placebo. Randomized controlled trial. Acta Obstet Gynecol Scand. 1999;78(9):793-8.

Gallot D, de Lapasse C, Houlle C, Sapin V, Laurichesse-Delmas H, Saulnier JP, et al. Obstetrical prognosis of labour induction with mifepristone after 41 weeks of gestation. Gynecol Obstet Fertil. 2004;32(9):708-12.

Wing DA, Fassett MJ, Mishell DR. Mifepristone for preinduction cervical ripening beyond 41 weeks' gestation: a randomized controlled trial. Randomized controlled trial. Obstet Gynecol. 2000;96(4):543-8.

Wing DA, Guberman C, Fassett M. A randomized comparison of oral mifepristone to intravenous oxytocin for labor induction in women with prelabor rupture of membranes beyond 36 weeks' gestation. Randomized controlled trial. Am J Obstet Gynecol. 2005 ;192(2):445-51.

Cabrol D, Dubois C, Cronje H, Gonnet JM, Guillot M, Maria B, et al. Induction of labor with mifepristone (RU 486) in intrauterine fetal death. Clinical Trial. Am J Obstet Gynecol. 1990;163(2):540-2.

Su H, Li E, Weng L. Mifepristone for induction of labor. Randomized controlled trial. Zhonghua Fu Chan Ke Za Zhi. 1996;31(11):676-80.

Berkane N, Verstraete L, Uzan S, Boog G, Maria B. Use of mifepristone to ripen the cervix and induce labor in term pregnancies. Randomized controlled trial. Am J Obstet Gynecol. 2005;192(1):114-20.