Comparative study of induction of labour with oral mifepristone and intracervical dinoprostone in primigravida

Abstract

Background: Mifepristone (RU-486) in doses of 200-400 mg has shown to improve cervical ripening. Hence the sequential use of Mifepristone followed by Dinoprostone is more effective in induction of labour with less chance of failed induction and thereby decreasing the caesarean delivery rate. Methods: A prospective comparative study was done for a period of 21 months from Oct 2021 to June 2020 in Dept. of OBG AIMS RC.170 primigravida with term gestation were included in the study.85 women (group A) were given 200 mg Mifepristone orally and 85 women (Group B) were induced with 0.5 mg intra cervical Dinoprostone gel. Bishop score was assessed after 6 hrs. Results: After the 1st assessment Bishop score was < 6 in 35.7% in group A, 28.8% in group B. Induction delivery interval was 9.61 hours in group A, 5.21 hours in group B (p≤0.001). 71.7% had vaginal delivery and 28.2% required LSCS in group A and 52.9% had vaginal delivery and 47.1% required LSCS in group B. There was no fetal mortality in both the groups Conclusion: Induction delivery interval was more in Group A compared to group B. However % of vaginal delivery was more in Group A compared to group B. Oral Mifepristone 200 mg can be used for cervical ripening during induction of labour, followed by intracervical Dinoprostone gel to reduce the number of caesarean deliveries.