Role of Mifepristone in Induction of Labor and Effect on Fetomaternal Outcome in Term Pregnancy

BACKGROUND: Mifepristone is a steroidal compound that has antiglucocorticoid and antiprogesterone properties. It increases uterine activity, causes cervical effacement and dilatation, needed for the delivery. An attempt is made in the present study to assess the efficacy of single dose of oral mifepristone in third trimester as cervical ripening for induction of labor, fetomaternal outcome in term pregnancy and to know the side-effects of oral mifepristone. METHOD: 100 women with term pregnancy (37-40 weeks) and Bishop score less than6 were recruited, and allocated into two groups. Women who received Tab. Mifepristone 200 mg orally were assigned in Study Group (n = 50) and who received placebo orally were assigned in Control Group (n = 50) At the end of 24 h, change in the Bishop’s score was assessed and Tab. Misoprostol 25 μg was administered intravaginally every 4 h, maximum 6 doses for induction/augmentation of labor. Analysis regarding safety and efficacy of the drug was done with regards to maternal and perinatal outcome. RESULT: 64 % of the patients were observed with improved Bishop’s score. Induction delivery interval was shorter in the study group and noteworthy feature is 46 % patients did not require even a single dose of Misoprostol after cervical ripening with Mifepristone suggesting that only Mifepristone may be only drug required in future for induction. Among the babies, 12 % in the control group required baby unit admission as compared to 04 % in the study group. CONCLUSION: In the present study, the women who were induced with mifepristone 200 mg per orally showed drastic improvement in cervical score within 24-48 hours and decreased the cesarean rate in the study group and amount of dose requirement of augmentation of labor with Misoprostol or Oxytocin, lesser NICU admission and maternal complication.