Journal of South Asian Federation of Obstetrics and Gynaecology

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VOLUME 15 , ISSUE 1 ( January-February, 2023 ) > List of Articles

ORIGINAL RESEARCH

Cervical Ripening Using Mifepristone before Induction of Labor in Term Pregnancy: Prospective Randomized Comparative Study

Nikita Sharma, Seetesh Ghose

Keywords : Labor induction and augmentation, Labor management, Neonatology

Citation Information : Sharma N, Ghose S. Cervical Ripening Using Mifepristone before Induction of Labor in Term Pregnancy: Prospective Randomized Comparative Study. J South Asian Feder Obs Gynae 2023; 15 (1):61-64.

DOI: 10.5005/jp-journals-10006-2186

License: CC BY-NC 4.0

Published Online: 19-04-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Abstract

Background: Mifepristone is a pharmacological agent (antiprogestin). When used in late pregnancy as an inducing agent, it antagonizes the action of progesterone at the cellular level and promotes cervical ripening. This study aims to compare the efficacy of mifepristone and prostaglandin (PGE2) gel for cervical ripening. Methodology: Women fulfilling inclusion criteria were enrolled either into the study group (mifepristone) or the control group (PGE2 gel). After assessment of the initial Bishop's score in both the groups, the study group was administered mifepristone 200 mg orally once and the control group was administered intracervical PGE2 gel at intervals of 6 hours for a maximum of three doses. Subsequent Bishop's score was assessed at 6, 12, 18, and 24 hours in both groups. An artificial rupture of membrane (ARM) with oxytocin augmentation was done when required. Parameters measured were the demographic profile of patients, Bishop's score, the requirement of misoprostol and augmentation with oxytocin, mode of delivery, induction delivery interval, outcome (successful/failed induction), appearance, pulse, grimace, activity, and respiration. (APGAR) score at 1 minute, and 5 minutes, neonatal intensive care unit (NICU) admission above 24 hours. Result: Improvement of Bishop's score was significantly higher in the control group at 6, 12, and 18 hours as compared to the study group. A total of 94% of patients required misoprostol only in the study group. Augmentation with oxytocin rate was higher in the control group (73%) as compared to the study group (71.1%). The induction delivery interval was significantly shorter in the control group with a p < 0.001. The vaginal delivery rate was higher in the study group. No significant difference was noted in neonatal outcomes in both groups. Conclusion: Mifepristone is not a better primary ripening agent than PGE2 gel.


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