Comparison of Mifepristone with Foley's Catheter for Induction of Labor in Post Dated Pregnancy

Background: Induction of labor is the forced initiation of uterine contractions after fetal viability when the benefits of delivery outweigh the risks of continuing the pregnancy. It is indicated in conditions where maternal or fetal complications may have an adverse effect on outcomes, especially in postdated pregnancies, which are known to be associated with risks of perinatal morbidity, mortality, and maternal complications. Antenatal ultrasound for the accurate estimation of the expected date of delivery has been demonstrated to reduce unnecessary inductions. These methods were selected based on their cost-effectiveness, safety profile, and favorable results reported in previous studies, with the objective of improving future management strategies for postdated pregnant women planned for induction of labou In this study, the induction of labor in postdated pregnancies was particularly examined.

Objectives: To compare the safety and efficacy of mifepristone and foley’s catheter for induction of labour in Post dated pregnancies.

Methodology: This randomized comparative study was carried out from January 2018 to December 2018 in the Department of Obstetrics and Gynaecology, Coimbatore Medical College Hospital. A total of 200 postdated pregnant women were selected according to the inclusion and exclusion criteria and written informed consent was taken. Detailed history, clinical examination, laboratory tests, and obstetric ultrasound were done in all the patients. Bishop’s score was calculated before the induction procedure. The patients were randomly divided into two groups: one group received mifepristone, and the other group received Foley’s catheter. After 24 hours, the results were analyzed on the basis of Bishop’s score change, requirement of further induction or augmentation, induction to delivery interval, type of delivery, neonatal outcome, and incidence of postpartum hemorrhage (PPH), to compare the efficacy of mifepristone and Foley’s catheter in postdated pregnancies.

Results: Among the 200 women included in the study, 100 received mifepristone and 100 underwent induction with Foley’s catheter; 135 were primigravida and 65 were multigravida, with a mean age of 24–25 years. Vaginal delivery was significantly higher in the mifepristone group (84%) compared to the Foley’s group (64%), while cesarean section rates were lower (16% vs. 33%). The mean induction–delivery interval was shorter with mifepristone (26 hours) than with Foley’s catheter (36 hours). Neonatal respiratory distress was less frequent in the mifepristone group (3%) compared to the Foley’s group (12%), and the incidence of postpartum hemorrhage was not statistically significant between the groups.

Conclusion: Thus, based on the results observed in our study, Tab. Mifepristone can be considered as effective in induction of labour in Post dated pregnancy.