Comparative Study of Efficacy and Safety of Mifepristone and Foley's Catheter in Induction of Labour

Background: Labour Induction the most common Obstetric intervention done all over the world and where many methods are experimented for the same. Mifepristone, an antiprogestin effectively used for labour induction in term pregnancies is an upcoming area of interest. Foley?s bulb induction is an ancient and effective method as inducing agent, Misoprostol (PGE1) has been in use more effectively from 1990?s for Induction of labour. Since there is no single novel drug for induction, which is more effective and universally accepted, there is always scope for research. Hence this is a study undertaken to compare Mifepristone and Foley?s bulb in induction of labour. Objectives: 1) To compare the efficacy and safety of mifepristone and Foley?s catheter insertion in induction of labor. 2) To compare the maternal and fetal outcome in both the groups. Methodology: Prospective Randomised Control Trial undertaken in 100 Pregnant women undergoing labour induction for various indications meeting the inclusion and exclusion criteria. Group A received Mifepristone 200mg PO, followed by 25mcg vaginal misoprostol 4th hourly for maximum of 4 doses and oxytocin accordingly deciding on Bishop?s score, In Group B Foley?s bulb inserted intracervically and inflated with 30ml of distilled water and followed similarly with misoprostol and oxytocin. Change in Bishop?s score, progress of labour induction to delivery interval, successful IOL and neonatal outcome noted. Results: The primary outcomes were -1) The improvement in Bishop?s score was similar in Mifepristone and Foley?s bulb group, i. e. 2.80 and 2.88 respectively 2) Mean induction to delivery interval which is comparatively short in Mifepristone group (20.50 hrs) compared to Foley?s bulb group (19.47 hrs) and was found to be not statistically significant(Pless than0.001). 3) Successful IOL - Labour natural was maximum in Mifepristone group-68% compared to 62% in Foley?s group. Conclusion: Foley?s catheter & Mifepristone are effective agents for cervical ripening which have comparable efficacy and negligible fetomaternal side effects.