A Prospective and Interventional Study of the Role of Low Dose Mifepristone in the Management of Uterine Leiomyoma in Perimenopausal Women
Journal Title: Saudi Journal of Medical and Pharmaceutical Sciences - Year 2017, Vol 3, Issue 10
Abstract
Abstract:The objective of this study is to determine the effect of progesterone antagonist, Mifepristone in perimenopausal women in decreasing the severity of symptoms like menorrhagia, dysmenorrhea, abdominal pain and urinary symptoms, in decreasing the fibroid volumeand uterine volume, in improving the hemoglobin percentage, in increasing the endometrial thickness, to look for the side effects profile and to look for the effects which were present at the end of treatment persisted during post treatment follow up. It is a prospective and interventional study doneamong the perimenopausal women with symptomatic fibroid uterus who came to the Gynecological OPD in Gandhi Hospital, Secunderabad for a period of one and half year in a sample size of 50 patients. After taking a detailed menstrual history and calculating Pictorial Blood loss Assessment Chart (PBAC) score for menorrhagia and Visual Analogue Scale (VAS) score for dysmenorrhea and abdominal pain, baseline fibroid and uterine volumes, haemoglobin percentage and endometrial thickness were noted and endometrial biopsy was done when endometrial thickness crossed≥8mm. The drug mifepristone 25 mg was given orally for a period of 3 months. The same parameters were measured after completion of 3 months of treatment and at another 3 months post treatment follow up. The values were compared with the values before treatment. Statistical analysis was done with paired t test and found whether the change in the variables before treatment, at the end of treatment and during post treatment follow up was significant or not. Menorrhagia was the most common symptom which made the patients to report to the hospital. After completing 3 months of treatment, menorrhagia, dysmenorrhea and abdominal pain decreased by 95.3%, 91.5% and 78.2% respectively. Fibroid volume and uterine volume decreased by 51.2% and 34.3% respectively, haemoglobin % increased by 13.9% and endometrial thickness by 24.8%. There were minimal tolerable side effects. At 3 months post treatment follow up also, there was improvement in symptomatology compared to before treatment. 25 mg oral mifepristone for 3 months effectively decreased menorrhagia, dysmenorrhea, abdnominal pain, decreased fibroid volume, uterine volume, improved haemoglobin% there by avoiding unnecessary surgery in perimenopausal women. Keywords:Mifepristone, fibroid, dysmenorrhoea.
Authors and Affiliations
Anupama Hari, Sruhya M
Keywords
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