DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20190867

Role of Mifepristone in treatment of uterine fibroid: an experience from tertiary care centre in South India

S. V. Nachiketha, Veena Hadi

Abstract


Background: Uterine fibroid are the most common benign tumour of the uterus and is seen in 20% of women in their reproductive age group. The aim of the study was to evaluate effect of Mifepristone on uterine fibroid with reference to reduction in size of fibroid and change in symptomatic profile.

Methods: It is a hospital based interventional study conducted at KIMS Hubli hospital. 98 patients with symptomatic fibroid uterus were given 50mg of Mifepristone on alternate day for 3 months.

Results: Mifepristone treatment significantly reduced mean PBAC score from baseline score of 212.61 to 20.39 at the end of 3rd month of therapy. Mean fibroid volume also reduced significantly from baseline value of 237.95cm3 to 30.45cm3 after 3 months of treatment. At the end of therapy hemoglobin was raised from 9.57g/dl at baseline to 10.42g/dl after 3 months of treatment. No major side effects were observed, and 7% patients had hysterectomy.

Conclusions: Mifepristone is very useful option in perimenopausal women with symptomatic fibroid. It reduces fibroid size and its symptoms without any major side effects. However, future long term RCTs are needed to assess the safety and efficacy of Mifepristone.


Keywords


Fibroid uterus, Mifepristone, PBAC scores, VAS score

Full Text:

PDF

References


Cramer SF, Patel A. The frequency of uterine leiomyomas. Am J Clinic Pathol. 1990;94(4):435-8.

Lurie S, Piper I, Woliovitch I, Glezerman M. Age-related prevalence of sonographicaly confirmed uterine myomas. J Obstet Gynaecol. 2005;25(1):42-4.

McDonald JW, Rosina A, Rizzi E, Colombo B. Age and fertility: can women wait until their early thirties to try for a first birth?. J Bios Sci. 2011;43(6):685-700.

Carlson KJ, Nichols DH, Schiff I. Indications for hysterectomy. New Eng J Med. 1993;328(12):856-60.

Maruo T, Matsuo H, Samoto T, Shimomura Y, Kurachi O, Gao Z, Wang Y, Spitz IM, Johansson E. Effects of progesterone on uterine leiomyoma growth and apoptosis. Ster. 2000;65(10-11):585-92.

Tiltman AJ. The effect of progestins on the mitotic activity of uterine fibromyomas. International journal of gynecological pathology: official journal of the International Soc Gynecol Pathol. 1985;4(2):89-96.

Kulshrestha V, Kriplani A, Agarwal N, Sareen N, Garg P, Hari S, Thulkar J. Low dose mifepristone in medical management of uterine leiomyoma-an experience from a tertiary care hospital from north India. Indian J Med Res. 2013;137(6):1154.

Higham JM, O'brien PM, Shaw R. Assessment of menstrual blood loss using a pictorial chart. BJOG: Int J Obstet Gynaecol. 1990;97(8):734-9.

Narvekar N, Critchley HO, Cheng L, Baird DT. Mifepristone-induced amenorrhoea is associated with an increase in microvessel density and glucocorticoid receptor and a decrease in stromal vascular endothelial growth factor. Human Reproduct. 2006;21(9):2312-8.

Murphy AA, Kettel LM, Morales AJ, Roberts VJ, Yen SS. Regression of uterine leiomyomata in response to the antiprogesterone RU 486. The J Clinic Endocrinol Metabol. 1993;76(2):513-7.

Angomchanu R, Kapur AN. role of mifepristone in conservative management of fibroids: fc4. 05. Bjog: An International Journal of Obstetrics and Gynaecol. 2014;121:43.

Seth S, Goel N, Singh E, Mathur AS, Gupta G. Effect of mifepristone (25 mg) in treatment of uterine myoma in perimenopausal woman. J Mid-Life Health. 2013;4(1):22.