Подготовка шейки матки к родам мифепристоном в разных дозах

Abstract

Aim: a comparison of the mifepristone in different doses effectiveness to prepare the cervix of uterus for delivery with its unsatisfactory "ripening" in 37-41 weeks pregnancy.
 
 Material and Subjects: the object of a continuous prospective study were 205 women who delivered babies in Maternity hospital №1 of town Tula for 2010-2011 yy with unsatisfactory "ripening" of the cervix at term pregnancy. Study groups was formed by a dosage of using the medical drug to prepare the cervix of uterus for delivery. Group IA was consisted of 177 pregnant women who received mifepristone peroral by a standard scheme, the group IB - 28 pregnant women who received mifepristone by the minimized scheme of the drug. The cervix of uterus readiness for childbirth was assessed by vaginal examination in accordance with the scale E.H. Bishop.
 
 Results: after medical treating by mifepristone "not ready enough" cervix of uterus were received the same results in both groups. The cervix of uterus condition improved to full readiness to 82,7% in IA and 83,3% cases in the IB group (OR=0,96; 95% CI of 0,23 to 4,0). In patients who initially had an "unripe" cervix of uterus after administration of mifepristone was noted significant improvement in her condition, - in group IA 66,4% of women had "ripe" cervix, in 24,8% were "not ripe enough" and 8,8% remained "unripe". In the IB group were obtained almost similar results: 60,0%, 30,0% and 10,0% respectively (p>0,05). It was´t found significant differences between groups in aspects of the delivery and the health status of newborns.
 
 Conclusion: the efficacy of mifepristone using in a dose of 200 mg 2 times with an interval of 24 hours to prepare the cervix of uterus for delivery is similar with the use of this drug in a dose of 100 mg 2 times with an interval of 24 hours for "not ripe enough" and acceptable for "unripe" cervix condition at 37-41 weeks of gestation. Pregnant women with a necessary the cervix of uterus preparation for to optimize hospital care perhaps the use of mifepristone in the outpatient setting for 3 days prior to hospitalization for childbirth.