A prospective study to compare oral mifepristone and dinoprostone gel in induction of labour in primigravida

Abstract

Induction of labour is defined as the process of artificially stimulating the uterus to start labour. Mifepristone is a synthetic steroid hormone analogue that has both antiprogesterone and antiglucocorticoid activities. It increases the sensitivity of the uterus to prostaglandins and facilitates labour. 2 Dinoprostone, is a naturally occurring prostagladin that is involved in promoting labour. The aim of this study was to compare the safety and efficacy of oral mifepristone with dinoprostone gel in induction of labour in primigravidas. To compare the safety and efficacy of oral mifepristone with dinoprostone gel in induction of labour at term. This was a hospital based prospective study conducted from August 2019 to January 2021.Group 1 involved primigravida who were given oral 200mg Mifepristone on an inpatient and primigravida in Group II were instilled with Dinoprostone gel 0.5mg without mifepristone ripening and further assessment were done in both groups. Progress of labour was seen and further augmentation done with oxytocin whenever required. Majority of the patients were between 39-41 weeks which shows almost equal distribution in both the group. It was observed that there was significant improvement in the Bishop’s score after administrating Mifepristone to the patients which was proved statistically significant (<0.004). Most of the patients delivered vaginally and was observed that there was 28% reduction in LSCS in Group I which was highly significant with p value < 0.004. We concluded that Mifepristone is a safe and efficient agent for cervical ripening and for initiation of labour in term patients as it causes improvement in bishops score and increase in vaginal delivery.