IJAR - Indian Journal of Applied Research

Dr JASIYA AFREEN M.H; Dr SUDHA C P

Volume : IX, Issue : VIII, August - 2019

EFFICACY OF ORAL MIFEPRISTONE 200MG IN PRE – INDUCTION CERVICAL RIPENING FOR INDUCTION OF LABOUR IN TERM PREGNANCY

Dr Jasiya Afreen M. H, Dr Sudha C P

Abstract :

INTRODUCTION: Mifepristone is a steroidal compound that has antiglucocorticoid and antiprogesterone properties. It increases uterine activity and causes cervical effacement and dilatation for pregnancy termination.A ripe or favorable cervix is a prerequisite for successful vaginal birth. Cochrane collaboration published in 2009 are of the opinion that there is insufficient information to support the use of mifepristone to induce labor. The present study was undertaken to find out the safety and efficacy of mifepristone for preinduction cervical ripening and labor induction in term pregnancy and to asses improvement in bishop score. AIMS AND OBJECTIVES: 1. To study efficacy of oral tab mifepristone 200mg as a cervical ripening agent for induction of labor. 2. To study improvement in bishop’s score. METHOD(S): One hundred women with single live fetus,term gestation,cephalic presentation,reactive fetal heart pattern and Bishops score < 6 were included in the study. After detailed history, examination, confirmation of diagnosis, investigations and after written informed consent, The participant will recieve Tab. mifepristone 200 mg orally. In all women, at the end of 24 hr and 48 hrs,, Bishop’s score was assessed. Once the patient’s bishop score has improved or gone into active labour further management will be according to the hospital protocol. When the women entered in active labor, ARM was done and if required Oxytocin drip was st arted for augmentation of labor, If fetal heart rate pattern remained normal with satisfactory progress of labor, these women were kept for vaginal delivery. If progress was unsatisfactory or variable fetal heart pattern, these women underwent cesarean s ection. The efficacy of mifepristone was assessed on the basis of improvement in Bishop score. RESULTS: After induction with mifepristone for cervical ripening in this study,71% primigravida and 12% multigravida who had bishop score <3 on admission had ce rvical score improved to >6 within 24 hours, at the end of 48 hours,bishop score had improved to >6 in 64% primigravida and 14% in multigravida. CONCLUSION :. Our study concludes that there was drastic improvement in bishop score within 24 – 48 hours of oral mifepristone and it is a safe and efficient agent for cervical ripening and for initiation of labor when given 24h – 48 hours prior to labor induction.