A Retrospective Case–Control Study Evaluating the Role of Mifepristone for Induction of Labor in Women with Previous Cesarean Section

Abstract

Objective To investigate the role of ''mifepristone'' for induction of labor (IOL) in pregnant women with prior cesarean section (CS).Methods In this retrospective study, all pregnant women with prior CS who received oral mifepristone (400 mg) for IOL (as per clear obstetric indications) [group 1] were compared with pregnant women with prior CS who had spontaneous onset of labor (SOL) [group 2], with respect to incidence of vaginal delivery, CS, duration of labor, and various maternal and fetal outcomes. Results During the study period, 72 women received mifepristone (group 1) for IOL and 346 had SOL (group 2). In group 1 after mifepristone administration, 40 (55.6 %) women had labor onset, and 24 (33.3 %) women had cervical ripening (Bishop Score C 8) within 48 h. There were no statistically significant differences with respect to duration of labor (p value: 0.681), mode of delivery (i.e., normal delivery or CS-p value: 0.076 or 0.120, respectively), or maternal (blood loss or scar dehiscence/rupture uterus), or fetal outcomes (NICU admission) compared to women with previous CS with SOL (group 2). However,

Outcomes of mifepristone usage for cervical ripening and induction of labour in full-term pregnancy. Randomized controlled trial

“…There were no differences in main neonatal outcomes in our study. The same results were found in other studies [26,27,29]. Bercane and coworkers (2005) did not find any signs of peripheral cortisol deprivation in the neonates despite the mifepristone concentration ratio between umbilical cord blood and maternal blood was 1:3 [16].…”

“…More recent studies showed improvement in cervical score within 24-48 h, decline the cesarean rate, amount of dose requirement of augmentation of labour, lesser NICU admission and maternal complication after mifepristone induction in term and prolonged pregnancy [25,26]. There is report of the use of mifepristone for induction of labour in women with previous cesarean section [27].…”

Mifepristone versus intracervical prostaglandin E2 gel for cervical ripening in primigravid patients at term

“…7 There is report of the use of Mifepristone for induction of labour in women with previous cesarean section. 8 Therefore, it is still of interest to continue studies, which will help to evaluate efficacy and safety of mifepristone for labor induction in full-term pregnancy.…”