Induction of labour with mifepristone versus misoprostol and pregnancy outcomes at a rural teaching hospital: A comparative study

Abstract

Introduction: Induction of labour is mainly attempted when continuation of pregnancy may harm either mother or foetus or both. Different methods of labour induction in full term pregnancy are widely practiced to prevent these complications. There are not enough studies on comparision of mifepristone and misoprostol for induction of labour in full term pregnancy. The present study compared the effectiveness and safety of induction of labour with mifepristone and with misoprostol.Methods: A hospital based, comparative study on hundred pregnant women admitted with term gestation at Mediciti Institute of Medical Sciences, Ghanpur was carried out from April 2018 to September 2019. Women were divided alternatively into 2 groups with 50 in each group (group 1 mifepristone 200 mg was given & in group 2 misoprostol was given). The primary outcome measures were successful vaginal delivery, induction to delivery interval (first dose of misoprostol / mifepristone to complete delivery of fetus and placenta) and secondary outcome measures were failed induction, mode of delivery, birth weight, meconium stained liquor, fetal distress, NICU admission, primary postpartum haemorrhage.Results: The mean age of women in group 1 and group 2 was 23 years and 27.8 years respectively. The mean BMI in both the groups was similar (22.63kg/m2 and 22.27kg/m2). The mean induction to delivery was 31.34hours in group 1 and in group 2, it was 15.79 hours. This was statistically significant in both groups with favourable and unfavourable cervix (p= 0.00001).Conclusion: Women induced with misoprostol had higher rates of successful vaginal delivery, shorter induction to delivery interval and better neonatal outcomes when compared to mifepristone.