Cervical maturation using mifepristone in women with normal pregnancies at or beyond term

Role of mifepristone in pre-induction cervical ripening: a double blind placebo-controlled study

“…Similar results regarding cervical changes with mifepristone have been reported by several other investigators in their studies in the past. [3][4][5][6][7][8][9][10]12 However, we were unable to demonstrate a beneficial effect of mifepristone on the incidence of spontaneous onset of labour in our population unlike other studies. A meta-analysis by Hapangama et al on role of mifepristone for labour induction also concluded that available data are insufficient to support the use of mifepristone to induce labour 11 We found no difference in the incidence of spontaneous labour between women treated with mifepristone or with placebo.…”

“…Considering mifepristone with its antiprogestogen action has been shown to increase cervical ripeness in various studies published earlier, we decided to study whether administration of mifepristone in the management scheme of these women with 'pastdatism' will have any beneficial effect in earlier onset of labour and faster delivery. [3][4][5][6][7][8][9][10] Therefore, we administered mifepristone (or placebo) to these women as soon as they crossed their EDD. We hoped that mifepristone would make more women have favourable cervices, resulting in higher rates of spontaneous labour or greater chances of successful labour induction (and therefore lower cesarean delivery rates).…”

“…mifepristone administration before giving labour induction with misoprostol. [3][4][5][6][7][8] At the end of 24 hours, there was no difference in the median Bishop score between the mifepristone and placebo group. Wing et al had speculated that longer exposure to mifepristone might be required to show a significant clinical difference in cervical ripening.…”

“…The usefulness of mifepristone in cervical ripening and labor induction has been reported by several studies since 1992. [3][4][5][6][7][8][9][10] Frydman et al first reported that mifepristone-treated term pregnancies were significantly more likely to go into spontaneous labor or present a ripe cervix for labour induction. 3 Kayastha et al reported similar benefits in post-cesarean pregnancies where labour induction was indicated.…”

“…11,12 Despite the available evidence that supports the use of mifepristone for cervical priming and labour induction at term, mifepristone is not being used routinely as an adjuvant for labour induction. [3][4][5][6][7][8][9][10] Not many studies on its role in cervical priming/labour induction have been published since review by Hapangama et al despite their call for more research to elucidate the role of mifepristone for this indication further. In this study, we compared mifepristone with placebo among women whose pregnancies had passed their estimated due date (EDD) and who were scheduled for labour induction at 41 weeks, on higher rates of favorable cervix and more possibilities of spontaneous labour.…”