A Retrospective Case–Control Study Evaluating the Role of Mifepristone for Induction of Labor in Women with Previous Cesarean Section

摘要

Objective To investigate the role of “mifepristone” for induction of labor (IOL) in pregnant women with prior cesarean section (CS). Methods In this retrospective study, all pregnant women with prior CS who received oral mifepristone (400?mg) for IOL (as per clear obstetric indications) [group 1] were compared with pregnant women with prior CS who had spontaneous onset of labor (SOL) [group 2], with respect to incidence of vaginal delivery, CS, duration of labor, and various maternal and fetal outcomes. Results During the study period, 72 women received mifepristone (group 1) for IOL and 346 had SOL (group 2). In group 1 after mifepristone administration, 40 (55.6?%) women had labor onset, and 24 (33.3?%) women had cervical ripening (Bishop Score?≥?8) within 48?h. There were no statistically significant differences with respect to duration of labor ( p value: 0.681), mode of delivery (i.e., normal delivery or CS— p value: 0.076 or 0.120, respectively), or maternal (blood loss or scar dehiscence/rupture uterus), or fetal outcomes (NICU admission) compared to women with previous CS with SOL (group 2). However, the need of oxytocin ( p value 0.020) and dose of oxytocin requirement ( p value 0.008) were more statistically significant in group 1. Conclusion Mifepristone may be considered as an agent for IOL in women with prior CS.