Thakur Vaidehi, Kamal Deep, Ramaraju H E, Chawla Sushil
Department of Obs/Gyn, Naval Hospital, Indian Navy, Powai, Mumbai, India.
Department of Medicine, Naval Hospital, Indian Navy, Powai, Mumbai, India.
J Obstet Gynaecol India. 2024 Jun;74(3):219-223. doi: 10.1007/s13224-023-01875-4. Epub 2023 Dec 16.
Modern-day obstetrics recommend induction of labor by medical or mechanical methods where continuation of pregnancy causes detrimental effect to the health of mother or fetus. One of the prerequisites for successful vaginal delivery includes a favorable or ripe cervix. We undertook the present study to find out the safety and efficacy of mifepristone for pre-induction cervical ripening and its effect on Bishop's score in term pregnancy.
A total of 100 patients with term pregnancy were enrolled for this study. 200 mg of mifepristone was administered orally, and efficacy of mifepristone was assessed based on improvement in modified Bishop's score at 48 h. If there was inadequate improvement in Bishop's score after 48 h, additional intracervical cerviprime was administered for induction.
Out of 100 patients, 50 women delivered vaginally after administration of mifepristone. Twenty-four patients delivered vaginally within 48 h of administration of mifepristone. We observed the Bishop's score of 6 or more at 48 h in 69% participants. Fifty patients required additional intracervical cerviprime. Thirty participants underwent cesarean section. Mean Modified Bishop's score at 0 h was 1.87 and improved to 6.92 after 48 h after mifepristone. A statistically significant difference was found with mean Bishop's score with value < 0.005.
In our study, we found that mifepristone is a safe and effective cervical ripening agent in term pregnancy with unfavorable cervix. It is well tolerated and leads to significant cervical ripening with improvement in Bishop's score favoring vaginal delivery.
现代产科建议在继续妊娠会对母亲或胎儿健康造成不利影响时，通过药物或机械方法引产。成功阴道分娩的前提条件之一是宫颈条件良好或成熟。我们开展本研究以探讨米非司酮用于引产术前宫颈成熟的安全性和有效性及其对足月妊娠Bishop评分的影响。
本研究共纳入100例足月妊娠患者。口服200 mg米非司酮，并根据48小时时改良Bishop评分的改善情况评估米非司酮的疗效。如果48小时后Bishop评分改善不足，则额外给予宫颈扩张素进行引产。
100例患者中，50例女性在服用米非司酮后经阴道分娩。24例患者在服用米非司酮后48小时内经阴道分娩。我们观察到69%的参与者在48小时时Bishop评分为6分或更高。50例患者需要额外给予宫颈扩张素。30例患者接受了剖宫产。0小时时改良Bishop评分的平均值为1.87，服用米非司酮48小时后提高到6.92。发现Bishop评分平均值存在统计学显著差异，P值<0.005。
在我们的研究中，我们发现米非司酮是一种用于宫颈条件不佳的足月妊娠的安全有效的宫颈成熟剂。它耐受性良好，可导致宫颈显著成熟，Bishop评分改善，有利于阴道分娩。
