- Predictional factors of efficiency of myfipristone in pre-induction cervical ripening
Predictional factors of efficiency of myfipristone in pre-induction cervical ripening
HEALTH OF WOMAN. 2018.1(127):40–42
Kravchenko О. V.
SHEIU «Bukovinian state medical University», Chernivtsi
The objective: to study clinical and ultrasound criteria, which are prognostically important in determining the effectiveness of pre-induction and induction of labor by mifepristone.
Materials and methods. 192 patients were examined during the gestation period of 40–42 weeks, with mifepristone (mirapriston) used to prepare the cervix for delivery.
The effectiveness of pre-induction preparation of mifepristone was assessed by the following criteria: maturation of the cervix, the need for additional induction methods, the independent initiation of regular labor, the development of abnormalities of labor, the frequency of delivery through the natural birth canal and by cesarean section, neonatal outcomes.
Results. It was found that before the reception of mifepristone the cervix was evaluated as «immature» in 59.9% of pregnant women, in 40.1% of patients it was «not mature enough». Self-sustained labor after pre-induction with mifepristone developed in 83.3% of women. 2.6% of pregnant women were operated in a planned manner due to the lack of effect from pre-induction training. In 16.7% of the patients, deliveries ended by an urgent cesarean section. The main prognostic factors for the effectiveness of pre-induction preparation are the length of the cervix, the age of the pregnant woman, the dose ratio of mifepristone and the body weight of the woman.
Conclusion. Use of mifepristone is a highly effective method of preparing the body for pregnant women to delivery. The appointment of mifepristone promotes spontaneous development of labor activity in 79.3% of pregnant women. The highest percentage of success in pre-induction with mifepristone was observed with a cervical length of 25 mm or less. The age of a pregnant woman over the age of 30 is a prognostic factor of the less effective mifepristone in preparing the cervix to delivery than before age 30. The dose ratio of mifepristone and the body weight of the patient have great prognostic value as for to the maturation of the cervix and for the characteristics of the course of the normal labor. The use of mifepristone does not lead to a negative effect of the fetal condition and involutive processes of myometrium in postpartum period.
Key words: efficacy factors, pre-induction preparation, mifepristone.
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