Efficacy and safety of oral mifepristone in induction of labour in prolonged pregnancy


Induction of labor
Prolonged pregnancy

How to Cite

Das, R., Subedi, N., Rajbhandari, S., & Gurung, G. (2022). Efficacy and safety of oral mifepristone in induction of labour in prolonged pregnancy. Journal of Kathmandu Medical College, 11(1), 42–47. Retrieved from https://jkmc.com.np/ojs3/index.php/journal/article/view/1135


Background: Induction of labour implies, achieving vaginal delivery by stimulating uterine contractions before spontaneous onset of labour. Prolonged pregnancy exceeding duration of expected date of delivery is associated with increased risk to foetus and most common indication for induction of labour.
Objectives: To study the safety and efficacy of oral mifepristone in induction of labour in prolonged pregnancy.
Methods: This experimental study was carried out in Universal College of Medical Sciences Teaching Hospital, Bhairahawa between June 2016 to June 2017 after ethical clearance. Total 102 women were included in the study with 51 participants in the study group (mifepristone) and 51 in the control group (misoprostol). Data were expressed in frequency and mean ± SD and analysed using Independent “t” test and Chi-square test. A p-value of <0.05 was considered significant. Safety and efficacy of the drug was analysed with regards to maternal and perinatal outcome.
Results: Single dose of mifepristone was sufficient enough for successful induction in 40 (78.43%) women in study group. Time interval from induction to delivery had maximum frequency of 6-12 hours in both groups (p-value 0.13). The active phase of labour lasted for 2-6 hours in 38 (74.5%) women of the study group. Around 27 (42.9%) women of study group required augmentation of labour and 49 (96.1%) women had vaginal delivery. There was no significant difference in perinatal outcome between both the groups.
Conclusion: Mifepristone combined with or without augmentation is safe, efficient, economical, and convenient induction agent for initiation of labour in prolonged pregnancies.



American College of Obstetricians Gynaecologists. Induction of labour. Int J Gynaecol Obstet. 1996 Apr;53(1):65-72. [PubMed | Full Text | DOI]

Frydman R, Lelaidier C, Baton-Saint-Mleux C, Fernandez H, Vial M, Bourget P. Labour induction in women at term with mifepristone (RU 486): A double-blind, randomized placebo-controlled study. Obstet Gynecol. 1992;80:972-5. [PubMed | Full Text | DOI]

Hapangama DK. Mifepristone: the multifaceted antihormone. J Drug Eval. 2003;1(5):149?75. [Full Text]

Hapangama D, Neilson JP. Mifepristone for induction of labour. Cochrane Database Syst Rev. 2009;(3):CD002865. [PubMed | Full Text | DOI]

Heikinheimo O. Clinical pharmacokinetics of mifepristone. Clin Pharmacokinet. 1997;33:7-17. [PubMed | Full Text | DOI]

Fairley TE, MacKenzie M, Owen P, MacKenzie F. Management of late intrauterine death using a combination of mifepristone and misoprostol: Experience of two regimens. Eur J Obstet Gynecol Reprod Biol. 2005;118(1):28-31. [PubMed | Full Text | DOI]

Bartley J, Tong S, Everington D, Baird DT. Parity is a major determinant of success rate in medical abortion: A retrospective analysis of 3161 consecutive cases of early medical abortion treated with reduced doses of mifepristone and vaginal gemeprost. Contraception. 2000;62(6):297-303. [PubMed | Full Text | DOI]

Athawale R, Acharya N, Samal S, Hariharan C. Effect of mifepristone in cervical ripening for induction of labour. Int J Reprod Contracept Obstet Gynecol. 2013;2(1):35-8. [Full Text | DOI]

Yelikar K, Deshpande S, Deshpande R, Lone D. Safety and efficacy of oral mifepristone in preinduction cervical ripening and induction of labour in prolonged pregnancy. J Obstet Gynaecol India. 2015 Jul;65(4):221-5. [PubMed | Full Text | DOI]

Wing D, Fassett M, Mishell DR. Mifepristone for preinduction cervical ripening beyond 41 weeks gestation: A randomised controlled trial. Obstet Gynecol. 2000;96(4):543-8. [PubMed | Full Text | DOI]

Shanitha F, Nayak SR, Rao B, Gandhi P, Shameem VPA. Mifepristone in the induction of labour at term. Int J Pharm Biomed Res. 2013;4(3):164-6. [Full Text]

Elliott CL, Brennand JE, Calder AA. The effects of mifepristone on cervical ripening and labour induction in primigravidae. Obstet Gynecol. 1998 Nov;92(5):804-9. [PubMed | DOI]

Stenlund PM, Ekman G, Aedo AR, Bygdeman M. Induction of labour with mifepristone : a randomized, double-blind study versus placebo. Acta ObstetGynecol Scand.1999;78:793-8. [ PubMed ]

Su H, Li E, Weng L. Mifepristone for induction of labour. Chinese Journal of Obstetrics and Gynaecology. 1996;31:676-80. [PubMed]

https:// pubmed.ncbi.nlm.nih.gov/9387530/ 15. Berkane N, Verstraete L, Uzan S, Boog G, Maria B. Use of mifepristone to ripen the cervix and induce labour in term pregnancies. Am J Obstet Gynecol.2005;192(1):114-20. [ PubMed | FullText | DOI ]

Giacalone PL, Targosz V, Laffargue F, Boog G, Faure JM. Cervical ripening with mifepristone before labour induction: A randomized study.Obstet Gynecol. 1998;92(4 Pt 1):487-92. [PubMed | Full Text | DOI]

Lelaidier C, Baton C, Benifla JL, Fernandez H, Bourget P, Frydman R. Mifepristone for labour induction after previous caesarean section. Br J Obstet Gynaecol. 1994;101:501-3. [PubMed | Full Text | DOI]

Dowswell T, Kelly AJ, Livio S, Norman JE, Alfirevic Z. Different methods for the induction of labour in outpatient settings. Cochrane Database Syst Rev.2010;(8):CD007701. [PubMed | Full Text | DOI]

Fassett MJ, Wing DA. Uterine activity after oral mifepristone administration in human pregnancies beyond 41 weeks’ gestation. Gynecol Obstet Invest. 2008;65(2):112-5. [PubMed | Full Text | DOI]