Mifepristone in Induction of Labor: A Potential Game Changer?

Labor induction, the artificial stimulation of uterine contractions, plays a significant role in modern obstetric practices. Mifepristone, a synthetic steroid hormone analog with anti-progesterone and anti-glucocorticoid properties, has emerged as a potential agent for inducing labor and facilitating cervical ripening. Vellanki J. et al. recently examined the efficacy and safety of mifepristone in labor induction.

Their study enrolled 100 antenatal cases admitted for safe confinement after reaching 37 completed weeks of gestation. Oral mifepristone, administered at a dose of 200 mg, was provided to the participants. The primary outcomes measured were cervical ripening and the need for further augmentation, evaluated based on the improvement in the Bishop's score within 24 hours of mifepristone administration.

The researchers found a significant enhancement in the Bishop's score 24 hours after mifepristone intake. 

Among the women who received mifepristone, 79% successfully delivered vaginally, while 21% required emergency cesarean section. Fetal distress was the primary indication for cesarean delivery in these cases.

Importantly, the majority of patients experienced favorable neonatal outcomes, and no serious maternal complications were reported.

The findings of this study highlight the effectiveness and safety of mifepristone as a method for labor induction. The observed improvement in the Bishop's score within 24 hours of mifepristone administration suggests its potential to facilitate cervical ripening and promote successful vaginal deliveries. Moreover, the absence of serious maternal complications and positive neonatal outcomes further support the safety profile of mifepristone in this context.

Vellanki J, Harmain Z, Limmala R K, Is mifepristone a game changer in induction of labour..?. Indian J Obstet Gynecol Res 2023;10(2):115-118