Mifepristone as cervical ripening agent for Labour induction in women with Previous one Caesarean Section

Background and Objective: Induction of labour is a common obstetric intervention. Women with a prior caesarean delivery have an increased risk of uterine rupture particularly when labour is induced. In women with previous one caesarean section, it is unclear which method of cervical ripening and labour induction is preferable. With this background current study was done to evaluate the efficacy and safety of mifepristone in women undergoing induction of labour at term after previous caesarean section. Material and Method: A total of 50 women who had a previous caesarean delivery with a low transverse uterine incision at 37-42 wk of gestation, having clear clinical indication for induction of labour with unfavorable cervical condition (Bishop’s score<5) were taken into the study. All women who meet the inclusion criteria received Tab Mifepristone 200 mg orally which was repeated after 24 hr. Reassessment of Bishop score was done after 48 hrs of first dose, and patient allowed to go into spontaneous labour. Labour was augmented with oxytocin infusion and/or ARM according to the progress of labour. Results: In our study mean pre induction Bishop’s score was 2.34±0.84 and mean post induction Bishop’s score was 8.24±1.65.In 35(70%) women labour was augmented with oxytocin and /or ARM, whereas 7(14%) women entered into spontaneous active labour and did not required any augmentation. In our study 42(84%) women delivered vaginally, only 8(16%) women had repeat caesarean section. No case of scar dehiscence or uterine rupture was seen. Conclusion: Mifepristone is a safe, efficient and suitable agent for cervical ripening and for initiation of labor when given 48hr before labour induction.