Predictors of successful labor preinduction with mifepristone

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Abstract

Relevance: Labor induction rates have increased worldwide in recent years. To make informed decisions, optimize resources, and minimize the risk of failure, it is important to develop new predictive tools for the preinduction of labor.

Objective: To determine predictors of successful labor preinduction/induction with mifepristone.

Materials and methods: We analyzed 5000 electronic delivery case records from 2016 to 2023. Of the total number of records, 236 were included in the study and divided into two groups. Group 1 consisted of pregnant women who reached full cervical ripening (Bishop scale score of 8 or higher) or developed regular labor contractions within 24 h of a single 200 mg dose of oral mifepristone (n=116). Group 2 comprised pregnant women who required additional labor preparation with a second dose of mifepristone and/or other labor preinduction techniques (n=120).

Results: Significant differences were found between the two groups in parity (p=0.029), history of induced abortion (p=0.031), acute respiratory viral infections (p=0.010), novel coronavirus infection (p=0.039), use of dydrogesterone (p=0.013), and presence of polyhydramnios in the third trimester of pregnancy (p=0.012). The Bishop scale score before preinduction was higher in Group 1, with a score 4 (3; 4), than in Group 2, with a score 3 (2; 3) (p<0.001). A predictive model with a sensitivity of 64.2% and specificity of 75.8% was developed to predict successful preinduction of labor.

Conclusion: The predictors of successful and rapid labor preinduction with mifepristone were the initial Bishop score, parity, and the presence of polyhydramnios. The relationship between previous viral infections and the use of progesterone preparations during pregnancy remains debatable.

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About the authors

Asiyat R. Gaidarova

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation

Author for correspondence.
Email: a_gadzhieva@oparina4.ru
ORCID iD: 0000-0003-1415-3318

PhD Student

Russian Federation, 117997, Moscow, Ac. Oparina str., 4

Oleg R. Baev

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation; I.M. Sechenov First Moscow State Medical University of Ministry of Health of Russia (Sechenov University)

Email: o_baev@oparina4.ru
ORCID iD: 0000-0001-8572-1971

Dr. Med. Sci., Professor, Head of the 1st Maternity Department, Professor at the Department of Obstetrics, Gynecology, Perinatology and Reproductology

Russian Federation, 117997, Moscow, Ac. Oparina str., 4; 119991, Moscow, Trubetskaya str., 8-2

Vladislava A. Gusar

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation

Email: v_gusar@oparina4.ru
ORCID iD: 0000-0003-3990-6224

PhD, Senior Researcher at the Laboratory of Applied Transcriptomics of the Department of Systems Biology in Reproduction

Russian Federation, 117997, Moscow, Ac. Oparina str., 4

Irina V. Edilberg

I.M. Sechenov First Moscow State Medical University of Ministry of Health of Russia (Sechenov University)

Email: i_edilberg@oparina4.ru
ORCID iD: 0000-0003-4194-8730

PhD Student

Russian Federation, 119991, Moscow, Trubetskaya str., 8-2

Oleg V. Tysyachnyi

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation

Email: o_tysyachny@oparina4.ru
ORCID iD: 0000-0001-9282-9817

PhD, Researcher at the 1st Maternity Department

Russian Federation, 117997, Moscow, Ac. Oparina str., 4

Aleksey A. Alekseev

Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation

Email: a_alekseev@oparina4.ru
ORCID iD: 0000-0002-5347-6884

Junior Researcher at the Laboratory of Cytology

Russian Federation, 117997, Moscow, Ac. Oparina str., 4

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