Comparative Analysis of Safety, Efficacy and Fetomaternal Outcome of Induction of Labor with Tablet Mifepristone and Tablet Misoprostol versus Tablet Misoprostol

Objectives: The present study aims at comparing the efficacy, safety and fetomaternal outcome of Misoprostol as cervical ripening and labor inducing agent versus Mifepristone and Misoprostol. The study also aims to observe the improvement in pre induction Bishop’s score, proportion of patients going in labor, to study induction–delivery interval.

Methods: It is randomized prospective studies conducted on 100 women. Women were randomized in group A and in group B of 50 patients in each group. Group A received tab Mifepristone 200 mg orally on day 1 followed by tablet Misoprostol 25 mcg after 48 hours and continued 4 hrly till patient went in active labor with maximum four tablets and group B patients received tablet Misoprostol 25mcg and continued 25mcg 4hrly till patient went in active labor.

Results: The study demonstrated significant efficacy of tablet Mifepristone for cervical ripening and induction of labor as pre induction Bishop’s score was improved. 32%patients went into labor only with tablet Mifepristone. The mean induction-delivery interval was 9.5 hrs in Group A and 11.78 hrs in Group B, 40% patients delivered by cesarean section in group A but it was not associated with any differences in final neonatal outcome in both the groups. Uterine hyper stimulation was present in 42% patients in group A as compared to only 20% patients in group B. Fetal distress was present in 38% of patients in group A as compared to 18% patients in group B. No any difference in final neonatal outcome was observed in both the groups.

Conclusion: Mifepristone pretreatment is more efficacious and significantly shortens the induction-delivery interval and it has got dual role as a cervical ripening and labor inducing agent.