A STUDY ON EFFICACY AND SAFETY OF ORAL MEFIPROSTONE FOR CERVICAL RIPENING AND INDUCTION OF LABOUR AND ITS OUTCOME IN PRIMIGRAVIDA

Cervical ripening is important prerequisite for induction of labour, induction is indicated when it is advantageous to mother and fetus. Successful induction of labour decreases caesarean rate. Induction of labor is a most common obstetric intervention. Commonly used drugs for induction of labor are prostaglandin analogues such as dinoprostone (PGE2) and misoprostol. Mifepristone/RU (486), a new class of drug is used for inducing labour in late pregnancy by antagonizing progesterone, thus increasing uterine contractility and by increasing the sensitivity of the uterus to the actions of prostaglandins. OBJECTIVES:- To study the efficacy of Mifepristone in priming the cervix or inducing labor in 24 hours in term pregnancy in primigravida.To study the improvement in bishop score.To study maternal and foetal outcome.

METHODOLOGY:- Total 50 women at term pregnancy, where pregnancy can be continued for another 24 hours with bishop score 3 or less were selected.Tablet Mifepristone 200 mg was given orally at admission after assessing BISHOP score and monitored. Bishop score was assessed at 24 hours. In women who did not enter labor spontaneously other modes of induction was done.

RESULTS:- There is significant and progressive improvement in bishop score at 24hr, the Mean bishop score at 24 hr is 7.04.Pre induction cervical ripening increases rate of vaginal delivery in mifepristone administered group by 64%, significant increase in spontaneous delivery rate 24%, seen among mifepristone administered group and decrease in caesarean section rate seen in mifepristone administered group. Mean induction to delivery interval was significantly decreased after cervical ripening with mifepristone.There was no significant adverse effect seen on mother and newborn compared to control group.

INTERPRETATION AND CONCLUSION: Cervicalripening with mifepristone prior to induction of labour at term improves bishop score and decreases rate of failed induction and cesarean section rate, with good neonatal outcome