ORAL MIFEPRISTONE AS A LABOUR INDUCING CERVICAL PRIMING AGENT

INTRODUCTION: Mifepristone is a 19 nor-Steroid, progestational and glucocorticoid hormone antagonist. During onset of spontaneous labour, there will be fall in the progesterone level, which is one of the most important event. Oral mifepristone progestational antagonist may be useful in induction of labour. AIM: To study the effectiveness and safety of Mifepristone as a cervical priming agent for induction of labour by comparing the effect of mifepristone in study group with a control group of same size and to determine the Maternal and fetal outcome. METHODOLOGY: This prospective clinical trial was carried out in the Department of Obstetrics and Gynecology, K.A.P.V Medical college & Mahatma Gandhi Memorial Hospital, Trichy during the period of June 2015 to November 2016 in 100 patients divided into study and control group equally. RESULTS: In this study, study population comprised of 100 patients with equal number of patients in the study and control group. There were no significant statistical differences between the treatment groups in demographics or medical or obstetrics history. Age distribution is also not statistically significant (p>0.05) Hence both the groups are comparable. The difference in distribution of the study population according to parity was not statistically significant (p>0.05) between the groups. Subjects in the Mifepristone group were not so different from subjects in placebo group with the respect to Bishop score at baseline as the mean difference is not statistically significant (p>0.05). However, Subjects in the Mifepristone group had a higher Bishop score after 24 hours than subjects in placebo group and this mean difference is statistically significant. Subjects in the Mifepristone group progressed about 6 hours (mean difference) earlier than subjects in placebo group to active stage of labor and this difference is statistically significant. Also the use of oral mifepristone shortened the duration from induction to active stage ranging from 5 hours to 7 hours based on the 95% confidence interval. Subjects in the Mifepristone group progressed to delivery in about 7 hours (mean difference) earlier than subjects in placebo group and this difference is statistically significant. CONCLUSION: From the study we conclude that mifepristone as a labour inducing cervical ripening agent had a better proven efficacy especially in primigravida women as similarly proved by various other earlier standard trials. The results from the studies are encouraging with no significant adverse effects on mother and fetus.