Mifepristone, NNU, Perinatal outcome, PGE2 gel
Citation Information :
Kumari S, Solanki V, Singh U, Mehrotra S. Comparative Study of Mifepristone with Dinoprostone Gel in Induction of Labor in Full-term Pregnancy: An Open-label Randomized Controlled Trial. J South Asian Feder Obs Gynae 2021; 13 (3):98-102.
Aim and objective: This study aims to compare the effectiveness and safety of mifepristone with PGE2 gel for cervical ripening and induction of labor.
Materials and methods: This was an open-label randomized controlled study; 191 patients were included and divided into 94 patients in group A (mifepristone) and 97 patients in group B (PGE2 gel). Tablet mifepristone 200 mg orally was given in group A, and intracervical PGE2 gel was given in group B. Preinduction Bishops score was noted at beginning to compare the improvement in Bishops score after induction. Mode of delivery and induction to delivery interval, complication, and neonatal outcome were noted in both groups.
Results: Change in Bishops score was noted after 24 hour, and it was comparable in both groups. Induction to delivery interval was significantly less in group B (29 hours) as compared to group A (34 hours). The rate of vaginal delivery was 62.5% in group A and 55.4% in group B. In group A 10.2% and 16.3% in group B required NNU admission.
Conclusion: Mifepristone is more effective than PGE2 gel for cervical ripening as it has high rate of vaginal delivery and good neonatal outcome.
Managing complication in pregnancy and childbirth: a guide for midwives and doctors. Geneva: World Health Organization; 2000.
Athawale R, Acharya N, Samal S, et al. Effect of Mifepristone in cervical ripening for induction of labour. Int J Reprod Contracept Obstet Gynecol 2013;2(1):35–38. DOI: 10.5455/2320-1770.ijrcog20130206.
Hapangama D, Neilson JP. Mifepristone for induction of labour. Cochrane Database Syst Rev 2009;2009(3):CD002865. DOI: 10.1002/14651858.CD002865.pub2.
Yellikar K, Deshpande S, Deshpande R, et al. Safety and efficacy of oral mifepristone in preinduction cervical ripening and induction of labor in prolonged pregnancy. J Obstet Gynaecol India 2015;65(4):221–225. DOI: 10.1007/s13224-014-0584-6.
Gupta A, Verma A, Madan I, et al. Efficacy and safety of oral mifepristone for cervical priming and induction of labor in term pregnancy. Int J Reprod Contracept Obstet Gynecol 2018;7(7):2766–2772. DOI: 10.18203/2320-1770.ijrcog20182878.
Sah M, Padhye S. Mifepristone versus intracervical prostaglandin E2 gel for cervical ripening in primigravid patients at term. Int J Reprod Contracept Obstet Gynecol 2018;7(3):824–828. DOI: 10.18203/2320-1770.ijrcog20180520.
Sailatha R, Famida AM, Chellaiyan VG, et al. Mifepristone: an alternate to dinoprostone in induction of labour. Int J Reprod Contracept Obstet Gynecol [Online] 2017;6(5):1880–1884. DOI: 10.18203/2320-1770.ijrcog20171941.
Dixit MS, Somalwar SA, Tathe GR. Effectiveness of isosorbide mononitrate vs prostaglandin E2 gel for cervical ripening: a study. J South Asian Feder Obstet Gynaecol 2019;11(5):288–291. DOI: 10.5005/jp-journals-10006-1712.
Pal R, Khalua T. Comparative analysis of safety, efficacy and fetomaternal outcome in term live pregnancy for induction of labour with oral mifepristone and intracervical dinoprostone gel. IOSR J Dent Med Sci 2018;17(4):77–81. Available from: www.iosrjournals.org.
Baev OR, Rumyantseva VP, Tysyachnyu OV, et al. Outcomes of mifepristone usage for cervical ripening and induction of labour in full-term pregnancy. Randomized controlled trial. Eur J Obstet Gynecol Reprod Biol 2017;217:144–149. DOI: 10.1016/j.ejogrb.2017.08.038.
Gaikwad V, Mittal B, Puri M. Comparative analysis of safety, efficacy and fetomaternal outcome of Induction of labor with mifepristone versus intracervical dinoprostone gel. Res J Pharm Biol Chem Sci 2014;5(2):611. ISSN: 0975-8585.
Arumugaselvi B, Sujathasenthil S, Anandan H. Comparative study of oral mifepristone and endocervical prostaglandins E2 gel as preinduction cervical ripening agent in parturition. Int J Sci Stud 2017;5(3):129–133.
Vijay C, Thomas A, Anand S, et al. Perinatal outcomes among women with cholestasis of pregnancy. J South Asian Feder Obstet Gynaecol 2020;12(5):295–301. DOI: 10.5005/jp-journals-10006-1827.
Jyoti R, Mahajan M, Gupta KB, et al. Comparison of oral and vaginal administration of low-dose misoprostol for labor induction. J South Asian Feder Obstet Gynaecol 2012;4(3):137–140. DOI: 10.5005/jp-journals-10006-1196.