Bama Ramesh, Vidyaravi, Mareeswari
BACKGROUND Mifepristone is a 19 nor-Steroid with a greater affinity for the progesterone receptor and thus blocks the action of progesterone at a cellular level. As a fall in the level of progesterone considered one of the important events in the onset of spontaneous labour, it therefore seems likely that this drug may be useful on induction. Aim- To study the effectiveness and safety of Mifepristone as a cervical priming agent for induction of labour to determine the Maternal and foetal outcome. MATERIALS AND METHODS This prospective clinical trial was carried out in the Department of Obstetrics and Gynaecology, K.A.P.V Medical College & Mahatma Gandhi Memorial Hospital, Trichy during the period of January 2016 to December 2016 in 100 patients divided into study and control group equally. RESULTS In this study, study population comprised of 100 patients with equal no of patients in the study and control group. 66 (66%) patients were primi gravida, 24 (24%) were multigravida, with no significant difference across the groups. The mean Bishop score at inclusion was 1.48 in the study group and 1.12 in the control group with no significant differences between the groups. The mean treatment to induction to active stage interval was 24.08 hours in the Mifepristone treated group when compared to 30.25 hours in the Prostaglandin treated group. Subjects in the Mifepristone group progressed about 6 hours (mean difference) earlier than subjects in placebo group to active stage of labour and this difference was statistically significant. Mean induction to delivery interval was 28.60 in Mifepristone group when compared to 35.44 in placebo group. The rate of normal and assisted vaginal deliveries was 96% in the mifepristone treated group when compared to 72% in the placebo treated group with a significant P value The rate of caesarean deliveries (28.3%) was comparably less in the mifepristone treated group than the Prostaglandin treated group (46.6%). CONCLUSION In our study we found that Mifepristone as a pre-induction cervical ripening agent had better proven efficacy especially in primi gravida women as similarly proved by various other earlier standard trials. The need for reinduction/augmentation with other cerviprime agents/oxytocics were also reduced in the Mifepristone treated groups. The results are encouraging with no significant adverse effects on mother and fetus.
