What is the role of mifepristone in cervical ripening and labor induction?

Label:chem

Topic
Mifepristone is an anti-progesterone drug that has been used historically for inducing abortion or managing non-viable pregnancies. It increases uterine sensitivity to prostaglandins but not to oxytocin. Over the last two decades, interest has grown in using mifepristone as a cervical ripening agent due to its anti-progesterone effects, its capacity to increase myometrial sensitivity to uterotonics, and its ability to cause very mild uterine contractility.
Answer
Mifepristone is used to ripen the cervix and induce labor in term pregnancies. This study evaluated whether a 200mg oral dose of mifepristone was non-inferior to an intracervical Foley balloon catheter for outpatient cervical ripening. The results showed that mifepristone achieved similar rates of onset of labor or favorable Bishop's score as the Foley balloon catheter, but it could not be shown to be non-inferior within the predefined margin of 10%. Mifepristone may be an alternative for cervical ripening, but further research is needed to determine optimal dosing and protocols.
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