Role of Mifepristone in Induction of Labor in Full-Term Pregnancy

Objective This study sought to evaluate the safety and efficacy of mifepristone as a uterine sensitizer in shortening induction to delivery time in term pregnancy. Study design A prospective study was carried out on primigravida with a singleton term pregnancy, cephalic presentation, 37 to 41 weeks gestation, Bishop score ≤6, and consented to the study. A total of 116 participants were divided into two groups by random computer-generated sequence. On admission, the Bishop score was assessed. Group A (n=58) received 200 mg of mifepristone. Group B (n=58) received a placebo orally. In both groups, a post-intervention assessment was done after 24 hours, intracervical dinoprostone gel was administered with a maximum of three doses, six hours apart, if the Bishop score was ≤6. The primary outcome was to evaluate the effectiveness of oral mifepristone based on Bishop score improvement, the need for dinoprostone gel, and induction to delivery time. The secondary outcome was to evaluate the safety of oral mifepristone based on cesarean section rate and fetomaternal outcome. Results The Bishop score markedly improved in group A after 24 hours of intervention. A total of 31 women delivered vaginally after receiving only mifepristone. Mean induction to delivery time significantly improved in group A at 23.22±12.57 hours as compared to that in group B at 38.79±7.32 hours. Cesarean delivery rate was lower in group A (27.59%) compared to group B (44.83%). Birth outcomes were consistent in both groups with no neonatal mortality. Conclusion Oral mifepristone has proved as a promising agent as a uterine sensitizer in inducing labor as it has significantly decreased induction to delivery time.