Comparative Analysis of Safety, Efficacy and Fetomaternal Outcome in Term Live Pregnancy for Induction of Labour with Oral Mifepristone and Intracervical Dinoprostone Gel
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 4
Abstract
Objective: To compare the efficacy of Mifepristone and Dinoprostone as a cervical ripening agent for induction of labour and also on the status of newborn. Methods: It is a single blind prospective randomized comparative study.One hundred antenatal cases as per the inclusion and exclusion criterias selected. Fifty women received 200mg oral mifepristone as cases and fifty women received 0.5mg dinoprostone gel intracervically as control. Pre induction Bishop’s score was assessed just before administration of the drug. Post induction Bishop’s score was assessed after 6 hr. in dinoprostone group and after 24 hr. in mifepristone group or with onset of labour, whichever was earlier. Oxytocin augmentation was started in cases with unsatisfactory progress of labour. The newborn was examined immediately after birth, the Apgar score being determined at 5 minutes. Any fetal abnormalities occurring in hospital were noted. All maternal side-effects were recorded. Results: In mifepristone group mean ± S.D of pre induction Bishop’s score was 5.04 ± 0.81 and in dinoprostone group it was 5.06 ± 0.71. Post induction Bishop’s score in mifepristone group mean ± S.D was 7.96 ±1.01 and in dinoprostone group it was 8.32 ± 1.08. Induction delivery interval in Mifepristone group (mean 28.72 hr.) was more than in dinoprostone group (mean 10.30hr). In mifepristone group 36 out of 50 needs oxytocin augmentation and in dinoprostone group 41 out of 50 needs oxytocin. So there was less oxytocin needed in mifepristone group. There were 11 cases of failed induction in mifepristone group and 13 cases of failed induction in dinoprostone group. Mifepristone group shows less number of failed induction. 2 cases of fetal distress in mifepristone group and 4 cases in dinoprostone group found. There was no significant statistical difference between the two groups (p value = 0.678). There were 36 vaginal delivery in mifepristone group and 31 in dinoprostone group. 13 cases need caesarean section in mifepristone group whereas 17 cases need in dinoprostone group. The number of instrumental delivery in mifepristone group was 1 and in dinoprostone group were 2. There was no significant statistical difference between the two groups (p value = 0.534). two babies in each group had an Apgar score of <7 at 5 minutes and there was no significant statistical difference between the two groups (p value =1.000).There were also two babies in each group need NICU admission and no significant statistical differences seen between the two groups (p value =1.000). The results of the present study show that mifepristone is a simple and effective treatment for inducing labour Conclusion: The results of the present study show that mifepristone is a simple and effective treatment for inducing labour. Mifepristone and Dinoprostone gel are comparable in fetomaternal outcome. Thus, mifepristone can be a safe alternative to dinoprostone gel in induction of labour, especially when prostaglandins are contraindicated.
Authors and Affiliations
Dr Rajib Pal, Dr Tufan Khalua
Keywords
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- EP ID EP370327
- DOI 10.9790/0853-1704017781.
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