Journal of South Asian Federation of Obstetrics and Gynaecology

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VOLUME 14 , ISSUE 2 ( March-April, 2022 ) > List of Articles

RESEARCH ARTICLE

Efficacy of Mifepristone in Preinduction Cervical Ripening in Term Pregnancy

S Sujithra, Syamala Onimi, Usha Rani Godla

Keywords : Mifepristone, Preinduction cervical ripening, Term gestation

Citation Information : Sujithra S, Onimi S, Godla UR. Efficacy of Mifepristone in Preinduction Cervical Ripening in Term Pregnancy. J South Asian Feder Obs Gynae 2022; 14 (2):184-188.

DOI: 10.5005/jp-journals-10006-2063

License: CC BY-NC 4.0

Published Online: 21-06-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Abstract

Objective: To study the efficacy of mifepristone in preinduction cervical ripening in term pregnancy. Study design: This is a prospective observational study, done in a tertiary care hospital. Fifty pregnant women in the study group were given oral mifepristone 200 mg for preinduction cervical ripening (second dose after 24 hours if applicable) and another 50 pregnant women who underwent expectant management were included in the expectant group. The primary objective was to assess the effect of mifepristone on the change in Bishop score. The secondary objective was to assess the induction–delivery interval and the mode of delivery. Results: In this study, the mean modified Bishop score 24 hours after oral mifepristone (single dose) was (7.34 ± 1.533) which was statistically significant compared to the expectant group's Bishop score (4.28 ± 1.179) p <0.001. Similarly, the mean modified Bishop score 48 hours after oral mifepristone (two doses) was 7.50 ± 0.57 which was statistically significant when compared to the expectant group (4.28 ± 1.155) p <0.001. The requirement for further inducing agents has also been significantly less in the study group compared to the expectant group (p <0.001). Twenty-four percent went into spontaneous labor within 24 hours of the first dose of oral mifepristone without the requirement of a prostaglandin E2 (PGE2) gel. Augmentation with oxytocin was required in 60% of the study group and 86% of the expectant group in active labor. The mean duration between the initiation of PGE2 gel induction and delivery was 13.45 ± 4.536 hours in the study group and 20.41 ± 3.896 hours (p <0.001). Spontaneous vaginal delivery was 82% in the study group and 80% in the expectant management group. Conclusion: Oral mifepristone given for preinduction cervical ripening was found to be effective and safe with a reduction in the need for additional prostaglandins and oxytocin and also shorter induction-to-delivery interval with no serious maternal or fetal adverse effects.


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  1. Wing DA, Passett MJ, Mishell DR. Mitepristone for pre induction cervical ripening beyond 41 weeks gestation: a randamixed controlled trial. Obset Gynecol 2000;96(4):543–548. DOI: 10.1016/s0029-7844(00)00947-9.
  2. Giacalone PL, Targosz V, Laffargue F, et al. Cervical ripening with mifepristone before labor induction: a randomized study. Obstet Gynecol 1998;92:487–492. DOI: 10.1016/s0029-7844(98)00225-7.
  3. Yelikar K, Deshpande S, Deshpande R, et al. Safety and efficacy of oral mifepristone in pre-induction cervical ripening and induction of labour in prolonged pregnancy. J Obstet Gynaecol India 2015;65(4):221–225. DOI: 10.1007/s13224-014-0584-6.
  4. 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.
  5. Elliott CL, Brennand JE, Calder AA. The effects of mifepristone on cervical ripening and labor induction in primigravidae. Obstet Gynecol 1998;92(5):804–809. DOI: 10.1016/s0029-7844(98)00284-1.
  6. El-Refaey H, Rajasekar D, Abdalla M, et al. Induction of abortion with mifepristone (RU 486) and oral or vaginal misoprostol. N Engl J Med 1995;332(15):983–987. DOI: 10.1056/NEJM199504133321502.
  7. Lata G, Rana N, Mittal R, et al. Mifepristone for cervical ripening and induction of labour. Int J Reprod Contracept Obstet Gynecol 2018;7(12):5041–5044. ISSN 2320-1789. DOI: 10.18203/2320-1770.ijrcog20184963.
  8. Li L, Gao W, Chen S. Labour induction in women at term with mifepristone and misoprostol. Chung Hua Fu Chan KoTsa Chih 1996;31(11):681–684. PMID: 9387531.
  9. Hapangama D, Neilson JP. Mifepristone for induction of labour. Cochrane Database Syst Rev 2009;2009(3):CD002865. DOI: 10.1002/14651858.CD002865.pub2.
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