Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2009 Jul 8;2009(3):CD002865.
doi: 10.1002/14651858.CD002865.pub2.

Mifepristone for induction of labour

Dharani Hapangama  1 , James P Neilson
Affiliations
Meta-Analysis

Mifepristone for induction of labour

Dharani Hapangama et al. Cochrane Database Syst Rev. .

Abstract

Background: The steroid hormone, progesterone, inhibits contractions of the pregnant uterus at all gestations. Antiprogestins (including mifepristone) have been developed to antagonise the action of progesterone, and have a recognised role in medical termination of early or mid-trimester pregnancy. Animal studies have suggested that mifepristone may also have a role in inducing labour in late pregnancy.

Objectives: To determine the effects of mifepristone for third trimester cervical ripening or induction of labour.

Search strategy: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register and reference lists of relevant papers (May 2009).

Selection criteria: Clinical trials comparing mifepristone used for third trimester cervical ripening or labour induction with placebo/no treatment or other labour induction methods.

Data collection and analysis: A strategy was developed to deal with the large volume and complexity of trial data relating to labour induction. This involved a two-stage method of data extraction. For this update, two review authors independently assessed trial quality and extracted data.

Main results: Ten trials (1108 women) are included. Compared to placebo, mifepristone treated women were more likely to be in labour or to have a favourable cervix at 48 hours (risk ratio (RR) 2.41, 95% confidence intervals (CI) 1.70 to 3.42) and this effect persisted at 96 hours (RR 3.40, 95% CI 1.96 to 5.92). They were less likely to need augmentation with oxytocin (RR 0.80, 95% CI 0.66 to 0.97). Mifepristone treated women were less likely to undergo caesarean section (RR 0.74, 95% CI 0.60 to 0.92) but more likely to have an instrumental delivery (RR 1.43, 95% CI 1.04 to 1.96). Women receiving mifepristone were less likely to undergo a caesarean section as a result of failure to induce labour (RR 0.40, 95% CI 0.20 to 0.80). There is insufficient evidence to support a particular dose but a single dose of 200 mg mifepristone appears to be the lowest effective dose for cervical ripening (increased likelihood of cervical ripening at 72 hours (RR 2.13, 95% CI 1.15 to 3.97). Abnormal fetal heart rate patterns were more common after mifepristone treatment (RR 1.85, 95% CI 1.17 to 2.93), but there was no evidence of differences in other neonatal outcomes. There is insufficient information on the occurrence of uterine rupture/dehiscence in the reviewed studies.

Authors' conclusions: There is insufficient information available from clinical trials to support the use of mifepristone to induce labour. However, the studies suggest that mifepristone is better than placebo in reducing the likelihood of caesarean sections being performed for failed induction of labour; therefore, this may justify future trials comparing mifepristone with the routine cervical ripening agents currently in use. There is little information on effects on the baby.

PubMed Disclaimer

Conflict of interest statement

None known.

Figures

1.1
1.1. Analysis
Comparison 1 (1.1) Mifepristone (all doses) versus placebo/no treatment: all women, Outcome 1 Vaginal delivery within 24 hours.
1.2
1.2. Analysis
Comparison 1 (1.1) Mifepristone (all doses) versus placebo/no treatment: all women, Outcome 2 Abnormal fetal heart rate pattern.
1.3
1.3. Analysis
Comparison 1 (1.1) Mifepristone (all doses) versus placebo/no treatment: all women, Outcome 3 Caesarean section.
1.5
1.5. Analysis
Comparison 1 (1.1) Mifepristone (all doses) versus placebo/no treatment: all women, Outcome 5 Labour/cervical ripening within 54 hours.
1.7
1.7. Analysis
Comparison 1 (1.1) Mifepristone (all doses) versus placebo/no treatment: all women, Outcome 7 Oxytocin augmentation.
1.8
1.8. Analysis
Comparison 1 (1.1) Mifepristone (all doses) versus placebo/no treatment: all women, Outcome 8 Abnormal neonatal follow‐up findings.
1.9
1.9. Analysis
Comparison 1 (1.1) Mifepristone (all doses) versus placebo/no treatment: all women, Outcome 9 Uterine dehiscence/rupture.
1.10
1.10. Analysis
Comparison 1 (1.1) Mifepristone (all doses) versus placebo/no treatment: all women, Outcome 10 Epidural analgesia.
1.11
1.11. Analysis
Comparison 1 (1.1) Mifepristone (all doses) versus placebo/no treatment: all women, Outcome 11 Instrumental vaginal delivery.
1.12
1.12. Analysis
Comparison 1 (1.1) Mifepristone (all doses) versus placebo/no treatment: all women, Outcome 12 Meconium‐stained liquor.
1.13
1.13. Analysis
Comparison 1 (1.1) Mifepristone (all doses) versus placebo/no treatment: all women, Outcome 13 Apgar score < 7 at 5 minutes.
1.14
1.14. Analysis
Comparison 1 (1.1) Mifepristone (all doses) versus placebo/no treatment: all women, Outcome 14 Neonatal intensive care unit admission.
1.15
1.15. Analysis
Comparison 1 (1.1) Mifepristone (all doses) versus placebo/no treatment: all women, Outcome 15 Neonatal jaundice.
1.16
1.16. Analysis
Comparison 1 (1.1) Mifepristone (all doses) versus placebo/no treatment: all women, Outcome 16 Perinatal death.
1.17
1.17. Analysis
Comparison 1 (1.1) Mifepristone (all doses) versus placebo/no treatment: all women, Outcome 17 Neonatal respiratory distress.
1.18
1.18. Analysis
Comparison 1 (1.1) Mifepristone (all doses) versus placebo/no treatment: all women, Outcome 18 Maternal adverse effects (all).
1.19
1.19. Analysis
Comparison 1 (1.1) Mifepristone (all doses) versus placebo/no treatment: all women, Outcome 19 Nausea.
1.20
1.20. Analysis
Comparison 1 (1.1) Mifepristone (all doses) versus placebo/no treatment: all women, Outcome 20 Vomiting.
1.21
1.21. Analysis
Comparison 1 (1.1) Mifepristone (all doses) versus placebo/no treatment: all women, Outcome 21 Diarrhoea.
1.23
1.23. Analysis
Comparison 1 (1.1) Mifepristone (all doses) versus placebo/no treatment: all women, Outcome 23 Uterine hyperstimulation.
1.24
1.24. Analysis
Comparison 1 (1.1) Mifepristone (all doses) versus placebo/no treatment: all women, Outcome 24 Vaginal delivery within 48 hours.
1.25
1.25. Analysis
Comparison 1 (1.1) Mifepristone (all doses) versus placebo/no treatment: all women, Outcome 25 Caesarean section for unsuccessful labour induction.
1.26
1.26. Analysis
Comparison 1 (1.1) Mifepristone (all doses) versus placebo/no treatment: all women, Outcome 26 Caesarean section for CTG abnormalities.
1.27
1.27. Analysis
Comparison 1 (1.1) Mifepristone (all doses) versus placebo/no treatment: all women, Outcome 27 Caesarean section for arrested labour.
1.28
1.28. Analysis
Comparison 1 (1.1) Mifepristone (all doses) versus placebo/no treatment: all women, Outcome 28 Labour/cervical ripening within 48 hours.
1.29
1.29. Analysis
Comparison 1 (1.1) Mifepristone (all doses) versus placebo/no treatment: all women, Outcome 29 Labour/cervical ripening within 72 hours.
1.30
1.30. Analysis
Comparison 1 (1.1) Mifepristone (all doses) versus placebo/no treatment: all women, Outcome 30 Labour/cervical ripening within 96 hours.
1.31
1.31. Analysis
Comparison 1 (1.1) Mifepristone (all doses) versus placebo/no treatment: all women, Outcome 31 Neonatal hypoglycaemia.
1.32
1.32. Analysis
Comparison 1 (1.1) Mifepristone (all doses) versus placebo/no treatment: all women, Outcome 32 Neonatal seizures.
2.1
2.1. Analysis
Comparison 2 (1.2) Mifepristone versus placebo: all women, unfavourable cervix, Outcome 1 Labour/cervical ripening within 54 hours.
2.2
2.2. Analysis
Comparison 2 (1.2) Mifepristone versus placebo: all women, unfavourable cervix, Outcome 2 Maternal adverse events (all).
2.3
2.3. Analysis
Comparison 2 (1.2) Mifepristone versus placebo: all women, unfavourable cervix, Outcome 3 Caesarean section.
2.4
2.4. Analysis
Comparison 2 (1.2) Mifepristone versus placebo: all women, unfavourable cervix, Outcome 4 Vaginal delivery within 24 hours.
2.6
2.6. Analysis
Comparison 2 (1.2) Mifepristone versus placebo: all women, unfavourable cervix, Outcome 6 Meconium‐stained liquor.
2.7
2.7. Analysis
Comparison 2 (1.2) Mifepristone versus placebo: all women, unfavourable cervix, Outcome 7 Oxytocin augmentation.
2.8
2.8. Analysis
Comparison 2 (1.2) Mifepristone versus placebo: all women, unfavourable cervix, Outcome 8 Abnormal neonatal follow‐up findings.
2.9
2.9. Analysis
Comparison 2 (1.2) Mifepristone versus placebo: all women, unfavourable cervix, Outcome 9 Uterine dehiscence/rupture.
2.10
2.10. Analysis
Comparison 2 (1.2) Mifepristone versus placebo: all women, unfavourable cervix, Outcome 10 Epidural analgesia.
2.11
2.11. Analysis
Comparison 2 (1.2) Mifepristone versus placebo: all women, unfavourable cervix, Outcome 11 Instrumental vaginal delivery.
2.12
2.12. Analysis
Comparison 2 (1.2) Mifepristone versus placebo: all women, unfavourable cervix, Outcome 12 Caesarean section for unsuccessful labour induction.
2.15
2.15. Analysis
Comparison 2 (1.2) Mifepristone versus placebo: all women, unfavourable cervix, Outcome 15 Caesarean section for CTG abnormalities.
2.16
2.16. Analysis
Comparison 2 (1.2) Mifepristone versus placebo: all women, unfavourable cervix, Outcome 16 Perinatal death.
2.17
2.17. Analysis
Comparison 2 (1.2) Mifepristone versus placebo: all women, unfavourable cervix, Outcome 17 Caesarean section for arrested labour.
2.20
2.20. Analysis
Comparison 2 (1.2) Mifepristone versus placebo: all women, unfavourable cervix, Outcome 20 Abnormal fetal heart pattern.
2.21
2.21. Analysis
Comparison 2 (1.2) Mifepristone versus placebo: all women, unfavourable cervix, Outcome 21 Diarrhoea.
2.22
2.22. Analysis
Comparison 2 (1.2) Mifepristone versus placebo: all women, unfavourable cervix, Outcome 22 Labour/cervical ripening within 48 hours.
2.23
2.23. Analysis
Comparison 2 (1.2) Mifepristone versus placebo: all women, unfavourable cervix, Outcome 23 Labour/cervical ripening within 72 hours.
2.24
2.24. Analysis
Comparison 2 (1.2) Mifepristone versus placebo: all women, unfavourable cervix, Outcome 24 Labour/cervical ripening within 96 hours.
2.25
2.25. Analysis
Comparison 2 (1.2) Mifepristone versus placebo: all women, unfavourable cervix, Outcome 25 Neonatal hypoglycaemia.
2.26
2.26. Analysis
Comparison 2 (1.2) Mifepristone versus placebo: all women, unfavourable cervix, Outcome 26 Neonatal seizures.
2.38
2.38. Analysis
Comparison 2 (1.2) Mifepristone versus placebo: all women, unfavourable cervix, Outcome 38 Apgar score < 7 at 5 minutes.
2.39
2.39. Analysis
Comparison 2 (1.2) Mifepristone versus placebo: all women, unfavourable cervix, Outcome 39 Neonatal intensive care unit admission.
2.40
2.40. Analysis
Comparison 2 (1.2) Mifepristone versus placebo: all women, unfavourable cervix, Outcome 40 Uterine hyperstimulation.
4.3
4.3. Analysis
Comparison 4 (1.10) Mifepristone versus placebo: all primiparae, Outcome 3 Caesarean section.
4.4
4.4. Analysis
Comparison 4 (1.10) Mifepristone versus placebo: all primiparae, Outcome 4 Labour/cervical ripening within 48 hours.
4.5
4.5. Analysis
Comparison 4 (1.10) Mifepristone versus placebo: all primiparae, Outcome 5 Labour/cervical ripening within 72 hours.
4.7
4.7. Analysis
Comparison 4 (1.10) Mifepristone versus placebo: all primiparae, Outcome 7 Neonatal hypoglycaemia.
4.9
4.9. Analysis
Comparison 4 (1.10) Mifepristone versus placebo: all primiparae, Outcome 9 Oxytocin augmentation.
4.11
4.11. Analysis
Comparison 4 (1.10) Mifepristone versus placebo: all primiparae, Outcome 11 Instrumental vaginal delivery.
4.14
4.14. Analysis
Comparison 4 (1.10) Mifepristone versus placebo: all primiparae, Outcome 14 Neonatal intensive care unit admission.
4.23
4.23. Analysis
Comparison 4 (1.10) Mifepristone versus placebo: all primiparae, Outcome 23 Uterine hyperstimulation.
4.26
4.26. Analysis
Comparison 4 (1.10) Mifepristone versus placebo: all primiparae, Outcome 26 Caesarean section for CTG abnormalities.
4.27
4.27. Analysis
Comparison 4 (1.10) Mifepristone versus placebo: all primiparae, Outcome 27 Caesarean section for arrested labour.
7.3
7.3. Analysis
Comparison 7 (1.29) Mifepristone versus placebo: all women, previous caesarean section, unfavourable cervix, Outcome 3 Caesarean section.
7.7
7.7. Analysis
Comparison 7 (1.29) Mifepristone versus placebo: all women, previous caesarean section, unfavourable cervix, Outcome 7 Labour/cervical ripening within 96 hours.
7.8
7.8. Analysis
Comparison 7 (1.29) Mifepristone versus placebo: all women, previous caesarean section, unfavourable cervix, Outcome 8 Neonatal hypoglycaemia.
7.9
7.9. Analysis
Comparison 7 (1.29) Mifepristone versus placebo: all women, previous caesarean section, unfavourable cervix, Outcome 9 Uterine dehiscence/rupture.
7.11
7.11. Analysis
Comparison 7 (1.29) Mifepristone versus placebo: all women, previous caesarean section, unfavourable cervix, Outcome 11 Instrumental vaginal delivery.
7.16
7.16. Analysis
Comparison 7 (1.29) Mifepristone versus placebo: all women, previous caesarean section, unfavourable cervix, Outcome 16 Perinatal death.
7.22
7.22. Analysis
Comparison 7 (1.29) Mifepristone versus placebo: all women, previous caesarean section, unfavourable cervix, Outcome 22 Other maternal side effects.
7.23
7.23. Analysis
Comparison 7 (1.29) Mifepristone versus placebo: all women, previous caesarean section, unfavourable cervix, Outcome 23 Uterine hyperstimulation.
7.26
7.26. Analysis
Comparison 7 (1.29) Mifepristone versus placebo: all women, previous caesarean section, unfavourable cervix, Outcome 26 Caesarean section for CTG abnormalities.
7.27
7.27. Analysis
Comparison 7 (1.29) Mifepristone versus placebo: all women, previous caesarean section, unfavourable cervix, Outcome 27 Caesarean section for arrested labour.
8.1
8.1. Analysis
Comparison 8 Mifepristone (all doses) versus oxytocin: all women with prelabour rupture of membranes beyond 36 weeks, Outcome 1 Vaginal delivery within 24 hours.
8.2
8.2. Analysis
Comparison 8 Mifepristone (all doses) versus oxytocin: all women with prelabour rupture of membranes beyond 36 weeks, Outcome 2 Caesarean section.
8.3
8.3. Analysis
Comparison 8 Mifepristone (all doses) versus oxytocin: all women with prelabour rupture of membranes beyond 36 weeks, Outcome 3 Epidural analgesia.
8.4
8.4. Analysis
Comparison 8 Mifepristone (all doses) versus oxytocin: all women with prelabour rupture of membranes beyond 36 weeks, Outcome 4 Meconium‐stained liquor.
8.5
8.5. Analysis
Comparison 8 Mifepristone (all doses) versus oxytocin: all women with prelabour rupture of membranes beyond 36 weeks, Outcome 5 Apgar score < 7 at 5 minutes.
8.6
8.6. Analysis
Comparison 8 Mifepristone (all doses) versus oxytocin: all women with prelabour rupture of membranes beyond 36 weeks, Outcome 6 Neonatal intensive care unit admission.
8.7
8.7. Analysis
Comparison 8 Mifepristone (all doses) versus oxytocin: all women with prelabour rupture of membranes beyond 36 weeks, Outcome 7 Maternal side effects (all).
8.8
8.8. Analysis
Comparison 8 Mifepristone (all doses) versus oxytocin: all women with prelabour rupture of membranes beyond 36 weeks, Outcome 8 Abnormal fetal heart rate pattern.
8.23
8.23. Analysis
Comparison 8 Mifepristone (all doses) versus oxytocin: all women with prelabour rupture of membranes beyond 36 weeks, Outcome 23 Uterine hyperstimulation.
8.25
8.25. Analysis
Comparison 8 Mifepristone (all doses) versus oxytocin: all women with prelabour rupture of membranes beyond 36 weeks, Outcome 25 Caesarean section for unsuccessful labour induction.
8.26
8.26. Analysis
Comparison 8 Mifepristone (all doses) versus oxytocin: all women with prelabour rupture of membranes beyond 36 weeks, Outcome 26 Caesarean section for CTG abnormalities.
8.27
8.27. Analysis
Comparison 8 Mifepristone (all doses) versus oxytocin: all women with prelabour rupture of membranes beyond 36 weeks, Outcome 27 Caesarean section for arrested labour.
9.1
9.1. Analysis
Comparison 9 Mifepristone single dose (50 mg) versus placebo, Outcome 1 Caesarean section.
9.2
9.2. Analysis
Comparison 9 Mifepristone single dose (50 mg) versus placebo, Outcome 2 Labour/cervical ripening within 72 hours.
9.3
9.3. Analysis
Comparison 9 Mifepristone single dose (50 mg) versus placebo, Outcome 3 Neonatal intensive care unit admission.
9.4
9.4. Analysis
Comparison 9 Mifepristone single dose (50 mg) versus placebo, Outcome 4 Instrumental vaginal delivery.
9.5
9.5. Analysis
Comparison 9 Mifepristone single dose (50 mg) versus placebo, Outcome 5 Neonatal hypoglyceamia.
9.6
9.6. Analysis
Comparison 9 Mifepristone single dose (50 mg) versus placebo, Outcome 6 Oxytocin augmentation.
9.7
9.7. Analysis
Comparison 9 Mifepristone single dose (50 mg) versus placebo, Outcome 7 Abnormal fetal heart pattern.
9.8
9.8. Analysis
Comparison 9 Mifepristone single dose (50 mg) versus placebo, Outcome 8 Apgar score < 7 at 5 minutes.
9.9
9.9. Analysis
Comparison 9 Mifepristone single dose (50 mg) versus placebo, Outcome 9 Labour/cervical ripening within 54 hours.
9.10
9.10. Analysis
Comparison 9 Mifepristone single dose (50 mg) versus placebo, Outcome 10 Uterine dehiscence/rupture.
9.11
9.11. Analysis
Comparison 9 Mifepristone single dose (50 mg) versus placebo, Outcome 11 Abnormal neonatal follow‐up findings.
9.15
9.15. Analysis
Comparison 9 Mifepristone single dose (50 mg) versus placebo, Outcome 15 Neonatal seizures.
9.23
9.23. Analysis
Comparison 9 Mifepristone single dose (50 mg) versus placebo, Outcome 23 Uterine hyperstimulation.
9.25
9.25. Analysis
Comparison 9 Mifepristone single dose (50 mg) versus placebo, Outcome 25 Caesarean section for unsuccessful labour induction.
9.26
9.26. Analysis
Comparison 9 Mifepristone single dose (50 mg) versus placebo, Outcome 26 Caesarean section for CTG abnormalities.
9.27
9.27. Analysis
Comparison 9 Mifepristone single dose (50 mg) versus placebo, Outcome 27 Caesarean section for arrested labour.
10.1
10.1. Analysis
Comparison 10 Mifepristone single dose (200 mg) versus placebo, Outcome 1 Caesarean section.
10.3
10.3. Analysis
Comparison 10 Mifepristone single dose (200 mg) versus placebo, Outcome 3 Neonatal intensive care unit admission.
10.4
10.4. Analysis
Comparison 10 Mifepristone single dose (200 mg) versus placebo, Outcome 4 Instrumental vaginal delivery.
10.5
10.5. Analysis
Comparison 10 Mifepristone single dose (200 mg) versus placebo, Outcome 5 Neonatal hypoglyceamia.
10.6
10.6. Analysis
Comparison 10 Mifepristone single dose (200 mg) versus placebo, Outcome 6 Oxytocin augmentation.
10.8
10.8. Analysis
Comparison 10 Mifepristone single dose (200 mg) versus placebo, Outcome 8 Abnormal neonatal follow‐up findings.
10.9
10.9. Analysis
Comparison 10 Mifepristone single dose (200 mg) versus placebo, Outcome 9 Apgar score < 7 at 5 minutes.
10.10
10.10. Analysis
Comparison 10 Mifepristone single dose (200 mg) versus placebo, Outcome 10 Labour/cervical ripening within 54 hours.
10.11
10.11. Analysis
Comparison 10 Mifepristone single dose (200 mg) versus placebo, Outcome 11 Vaginal delivery within 24 hours.
10.13
10.13. Analysis
Comparison 10 Mifepristone single dose (200 mg) versus placebo, Outcome 13 Labour/cervical ripening within 72 hours.
10.19
10.19. Analysis
Comparison 10 Mifepristone single dose (200 mg) versus placebo, Outcome 19 Abnormal fetal heart pattern.
10.20
10.20. Analysis
Comparison 10 Mifepristone single dose (200 mg) versus placebo, Outcome 20 Uterine dehiscence/rupture.
10.23
10.23. Analysis
Comparison 10 Mifepristone single dose (200 mg) versus placebo, Outcome 23 Uterine hyperstimulation.
10.25
10.25. Analysis
Comparison 10 Mifepristone single dose (200 mg) versus placebo, Outcome 25 Caesarean section for unsuccessful labour induction.
10.26
10.26. Analysis
Comparison 10 Mifepristone single dose (200 mg) versus placebo, Outcome 26 Caesarean section for CTG abnormalities.
10.27
10.27. Analysis
Comparison 10 Mifepristone single dose (200 mg) versus placebo, Outcome 27 Caesarean section for arrested labour.
11.1
11.1. Analysis
Comparison 11 Mifepristone single dose (400 mg) versus placebo, Outcome 1 Caesarean section.
11.3
11.3. Analysis
Comparison 11 Mifepristone single dose (400 mg) versus placebo, Outcome 3 Neonatal intensive care admission.
11.4
11.4. Analysis
Comparison 11 Mifepristone single dose (400 mg) versus placebo, Outcome 4 Instrumental vaginal delivery.
11.5
11.5. Analysis
Comparison 11 Mifepristone single dose (400 mg) versus placebo, Outcome 5 Neonatal hypoglyceamia.
11.6
11.6. Analysis
Comparison 11 Mifepristone single dose (400 mg) versus placebo, Outcome 6 Oxytocin augmentation.
11.8
11.8. Analysis
Comparison 11 Mifepristone single dose (400 mg) versus placebo, Outcome 8 Abnormal neonatal follow‐up findings.
11.11
11.11. Analysis
Comparison 11 Mifepristone single dose (400 mg) versus placebo, Outcome 11 Uterine dehiscence/rupture.
11.12
11.12. Analysis
Comparison 11 Mifepristone single dose (400 mg) versus placebo, Outcome 12 Labour/cervical ripening within 54 hours.
11.13
11.13. Analysis
Comparison 11 Mifepristone single dose (400 mg) versus placebo, Outcome 13 Apgar score < 7 at 5 minutes.
11.14
11.14. Analysis
Comparison 11 Mifepristone single dose (400 mg) versus placebo, Outcome 14 Neonatal intensive care unit admission.
11.15
11.15. Analysis
Comparison 11 Mifepristone single dose (400 mg) versus placebo, Outcome 15 Abnormal fetal heart rate pattern.
11.23
11.23. Analysis
Comparison 11 Mifepristone single dose (400 mg) versus placebo, Outcome 23 Uterine hyperstimulation.
11.25
11.25. Analysis
Comparison 11 Mifepristone single dose (400 mg) versus placebo, Outcome 25 Caesarean section for unsuccessful labour induction.
11.26
11.26. Analysis
Comparison 11 Mifepristone single dose (400 mg) versus placebo, Outcome 26 Caesarean section for CTG abnormalities.
11.27
11.27. Analysis
Comparison 11 Mifepristone single dose (400 mg) versus placebo, Outcome 27 Caesarean section for arrested labour.
11.28
11.28. Analysis
Comparison 11 Mifepristone single dose (400 mg) versus placebo, Outcome 28 Labour/cervical ripening within 48 hours.
11.32
11.32. Analysis
Comparison 11 Mifepristone single dose (400 mg) versus placebo, Outcome 32 Neonatal seizures.
12.1
12.1. Analysis
Comparison 12 Mifepristone single dose (600 mg) versus placebo, Outcome 1 Caesarean section.
12.2
12.2. Analysis
Comparison 12 Mifepristone single dose (600 mg) versus placebo, Outcome 2 Labour/cervical ripening within 54 hours.
12.3
12.3. Analysis
Comparison 12 Mifepristone single dose (600 mg) versus placebo, Outcome 3 Neonatal intensive care admission.
12.4
12.4. Analysis
Comparison 12 Mifepristone single dose (600 mg) versus placebo, Outcome 4 Neonatal hypoglyceamia.
12.6
12.6. Analysis
Comparison 12 Mifepristone single dose (600 mg) versus placebo, Outcome 6 Apgar scores < 7 at 5 minutes.
12.7
12.7. Analysis
Comparison 12 Mifepristone single dose (600 mg) versus placebo, Outcome 7 Instrumental vaginal deliveries.
12.8
12.8. Analysis
Comparison 12 Mifepristone single dose (600 mg) versus placebo, Outcome 8 Abnormal neonatal follow‐up findings.
12.15
12.15. Analysis
Comparison 12 Mifepristone single dose (600 mg) versus placebo, Outcome 15 Uterine dehiscence/rupture.
12.16
12.16. Analysis
Comparison 12 Mifepristone single dose (600 mg) versus placebo, Outcome 16 Abnormal fetal heart rate pattern.
12.23
12.23. Analysis
Comparison 12 Mifepristone single dose (600 mg) versus placebo, Outcome 23 Uterine hyperstimulation.
12.25
12.25. Analysis
Comparison 12 Mifepristone single dose (600 mg) versus placebo, Outcome 25 Caesarean section for unsuccessful labour induction.
12.26
12.26. Analysis
Comparison 12 Mifepristone single dose (600 mg) versus placebo, Outcome 26 Caesarean section for CTG abnormalities.
12.27
12.27. Analysis
Comparison 12 Mifepristone single dose (600 mg) versus placebo, Outcome 27 Caesarean section for arrested labour.
13.1
13.1. Analysis
Comparison 13 MIfepristone single dose (100 mg) versus placebo, Outcome 1 Caesarean section.
13.2
13.2. Analysis
Comparison 13 MIfepristone single dose (100 mg) versus placebo, Outcome 2 Labour/cervical ripening within 54 hours.
13.3
13.3. Analysis
Comparison 13 MIfepristone single dose (100 mg) versus placebo, Outcome 3 Neonatal intensive care unit admission.
13.4
13.4. Analysis
Comparison 13 MIfepristone single dose (100 mg) versus placebo, Outcome 4 Instrumental vaginal delivery.
13.5
13.5. Analysis
Comparison 13 MIfepristone single dose (100 mg) versus placebo, Outcome 5 Neonatal hypoglycaemia.
13.6
13.6. Analysis
Comparison 13 MIfepristone single dose (100 mg) versus placebo, Outcome 6 Abnormal fetal heart rate pattern.
13.7
13.7. Analysis
Comparison 13 MIfepristone single dose (100 mg) versus placebo, Outcome 7 Apgar score < 7 at 5 minutes.
13.8
13.8. Analysis
Comparison 13 MIfepristone single dose (100 mg) versus placebo, Outcome 8 Abnormal neonatal follow‐up findings.
13.15
13.15. Analysis
Comparison 13 MIfepristone single dose (100 mg) versus placebo, Outcome 15 Uterine dehiscence/rupture.
13.23
13.23. Analysis
Comparison 13 MIfepristone single dose (100 mg) versus placebo, Outcome 23 Uterine hyperstimulation.
13.25
13.25. Analysis
Comparison 13 MIfepristone single dose (100 mg) versus placebo, Outcome 25 Caesarean section for unsuccessful labour induction.
13.26
13.26. Analysis
Comparison 13 MIfepristone single dose (100 mg) versus placebo, Outcome 26 Caesarean section for CTG abnormalities.
13.27
13.27. Analysis
Comparison 13 MIfepristone single dose (100 mg) versus placebo, Outcome 27 Caesarean section for arrested labour.
See this image and copyright information in PMC

Update of

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

References to studies included in this review

Berkane 2005 {published data only}
    1. Berkane N, Verstraete L, Uzan S, Boog G, Maria B. Use of mifepristone to ripen the cervix and induce labor in term pregnancies. American Journal of Obstetrics and Gynecology 2005;192(1):114‐20. - PubMed
Elliot 1998 {published data only}
    1. Elliot C, Brennand JE, Calder AA. The effect of mifepristone (RU486) on cervical ripening and induction of labour in human pregnancy at term. 27th British Congress of Obstetrics & Gynaecology; 1995; 4‐7 July, Dublin. 1995:207.
    1. Elliott CL, Brennand JE, Calder AA. The effects of mifepristone on cervical ripening and labor induction in primigravidae. Obstetrics & Gynecology 1998;92(5):804‐9. - PubMed
Frydman 1992 {published data only}
    1. Frydman R, Baton C, Lelaidier C, Vial M, Bourget P, Fernandez H. Mifepristone for induction of labour. Lancet 1991;337:488‐9. - PubMed
    1. Frydman R, Lelaidier C, Baton‐Saint‐Mleux C, Fernandez H, Vial M, Bourget P. Labor induction in women at term with mifepristone (RU 486): a double blind, randomized, placebo‐controlled study. Obstetrics & Gynecology 1992;80:972‐5. - PubMed
    1. Frydman R, Lelaidier C, Baton‐Saint‐Mleux C, Fernandez H, Vial M, Bourget P. Labor induction in women at term with mifepristone (RU 486): a double‐blind, randomized, placebo‐controlled study. International Journal of Gynaecology & Obstetrics 1993;42:220. - PubMed
    1. Frydman R, Taylor S, Paoli C, Pourade A. Ru 486 (mifepristone): A new tool for labour induction in term women with fetus alive [Le RU 486 (mifepristone) un novel outil pour le declenchment du travail a terme]. Contraception, Fertilite, Sexualite 1992;20(12):1133‐6. - PubMed
    1. Lelaidier C, Benifla JL, Fernandez H, Baton C, Borget P, Bourrier MC, et al. RU 486 (mifepristone) in medical indications for labour induction in pregnancies at term: results of a randomized, double‐blind study of RU 486 vs placebo [Interet du RU 486 (Mifepristone) dans les indications medicales de declenchement du travail a terme]. Journal de Gynecologie, Obstetrique et Biologie de la Reproduction 1993;22:91‐100. - PubMed
Giacalone 1998 {published data only}
    1. Giacalone PL, Targosz V, Laffargue F, Boog G, Faure JM. Cervical ripening with mifepristone before labor induction: a randomized study. Obstetrics & Gynecology 1998;92(4 Pt 1):487‐92. - PubMed
Lelaidier 1994 {published data only}
    1. Lelaidier C, Baton C, Benifla JL, Fernandez H, Bourget P, Frydman R. Mifepristone for labour induction after previous caesarean section. British Journal of Obstetrics and Gynaecology 1994;101:501‐3. - PubMed
Stenlund 1999 {published data only}
    1. Stenlund PM, Bygdeman M, Ekman G. Induction of labor with mifepristone (RU 486). A randomized double‐blind study in post‐term pregnant women with unripe cervices. Acta Obstetricia et Gynecologica Scandinavica. Supplement 1994;73(161):Abstract no: FP50. - PubMed
    1. Stenlund PM, Ekman G, Aedo AR, Bygdeman M. Induction of labor with mifepristone ‐ a randomized, double‐blind study versus placebo. Acta Obstetricia et Gynecologica Scandinavica 1999;78:793‐8. - PubMed
Su 1996 {published data only}
    1. Su H, Li E, Weng L. Mifepristone for induction of labor. Chinese Journal of Obstetrics and Gynaecology 1996;31:676‐80. - PubMed
Thakur 2005 {published data only (unpublished sought but not used)}
    1. Thakur V, Dorman E, Sanu L, Harrington K. Mifepristone is an effective ripening agent in postdates primips with cervical length >2.5cm, but mode of delivery correlates with birthweight: a randomised, placebo controlled double blind study. Ultrasound in Obstetrics and Gynecology 2005;26:452.
Wing 2000 {published data only}
    1. Byrne JD, Wing DA, Fraser M, Fassett MJ, Goodwin TM, Challis JRG. Mifepristone: effect on plasma corticotropin‐releasing hormone, adrenocorticotropin hormone, and cortisol in term pregnancy. Journal of Perinatology 2004;24(7):416‐20. - PubMed
    1. Fassett MJ, Lachelin GC, McGarrigle HH, Wing DA. Alterations in saliva steroid hormone levels after oral mifepristone administration in women with pregnancies of greater than 41 weeks' gestation. Reproductive Sciences 2008;15(4):394‐9. - PubMed
    1. Fassett MJ, Wing DA. Salivary estriol/progesterone ratio and the success of labor induction [abstract]. American Journal of Obstetrics and Gynecology 2001;185(6 Suppl):S210.
    1. Fassett MJ, Wing DA. Uterine activity after oral mifepristone administration in human pregnancies beyond 41 weeks' gestation. Gynecologic and Obstetric Investigation 2008; Vol. 65, issue 2:112‐5. - PubMed
    1. Wing D, Fassett M, Mishell DR. Mifepristone for preinduction cervical ripening beyond 41 weeks gestation: A randomised controlled trial. Obstetrics & Gynecology 2000;96(4):543‐48. - PubMed
Wing 2005 {published data only}
    1. Wing D, Guberman C, Fassett M. A comparison of oral mifepristone to intravenous oxytocin for pre‐induction cervical ripening and labour induction in women with pre‐labour rupture of membranes beyond 36 weeks gestation. American Journal of Obstetrics & Gynecology 2003;189(6 Suppl 1):S204. - PubMed
    1. Wing DA, Guberman C, Fassett M. A randomized comparison of oral mifepristone to intravenous oxytocin for labor induction in women with prelabor rupture of membranes beyond 36 weeks' gestation. American Journal of Obstetricians & Gynaecologists 2005;192:445‐51. - PubMed

References to studies excluded from this review

Cabrol 1990 {published data only}
    1. Cabrol D, Dubois C, Cronje H Gonnet JM, Guillot M, Maria, B, et al. Induction of labor with mifepristone (RU 486) in intrauterine fetal death. American Journal of Obstetrics and Gynecology 1990;163:540‐2. - PubMed
Jiang 1997 {published data only}
    1. Jiang X, Wang H, Zhang Z. Determination of fetal umbilical artery flow velocity during induction of term labour by mifepristone. Chinese Journal of Obstetrics & Gynecology 1997;32(12):732‐4. - PubMed
Li 1996 {published data only}
    1. Li L, Gao W, Chen S. Labour induction in women at term with mifepristone and misoprostol. Chung Hua Fu Chan Ko Tsa Chih 1996;31:681‐4. - PubMed
Padayachi 1988 {published data only}
    1. Padayachi T, Norman RJ, Moodley J, Heyns A. Mifepristone and induction of labour in second half of pregnancy. Lancet 1988;1:647. - PubMed

Additional references

Alfirevic 2006
    1. Alfirevic Z, Weeks A. Oral misoprostol for induction of labour. Cochrane Database of Systematic Reviews 2006, Issue 2. [DOI: 10.1002/14651858.CD001338.pub2] - DOI - PubMed
Bartley 2000
    1. Bartley J, Tong S, Everington D, Baird DT. Parity is a major determinant of success rate in medical abortion: a retrospective analysis of 3161 consecutive cases of early medical abortion treated with reduced doses of mifepristone and vaginal gemeprost. Contraception 2000;62(6):297‐303. - PubMed
Boulvain 2001
    1. Boulvain M, Kelly A, Lohse C, Stan C, Irion O. Mechanical methods for induction of labour. Cochrane Database of Systematic Reviews 2001, Issue 4. [DOI: 10.1002/14651858.CD001233] - DOI - PubMed
Boulvain 2005
    1. Boulvain M, Stan C, Irion O. Membrane sweeping for induction of labour. Cochrane Database of Systematic Reviews 2005, Issue 1. [DOI: 10.1002/14651858.CD000451.pub2] - DOI - PMC - PubMed
Boulvain 2008
    1. Boulvain M, Kelly AJ, Irion O. Intracervical prostaglandins for induction of labour. Cochrane Database of Systematic Reviews 2008, Issue 1. [DOI: 10.1002/14651858.CD006971] - DOI - PubMed
Bricker 2000
    1. Bricker L, Luckas M. Amniotomy alone for induction of labour. Cochrane Database of Systematic Reviews 2000, Issue 4. [DOI: 10.1002/14651858.CD002862] - DOI - PMC - PubMed
Clarke 1999
    1. Clarke M, Oxman AD, editors. Cochrane Reviewers' Handbook 4.0 [updated July 1999]. In: Review Manager (RevMan) [Computer program]. Version 4.0 Oxford, England: The Cochrane Collaboration, 1999.
Curtis 1987
    1. Curtis P, Evans S, Resnick J. Uterine hyperstimulation. The need for standard terminology. Journal of Reproductive Medicine 1987;32:91‐5. - PubMed
Dlamini 1995
    1. Dlamini BJ, Anderson LL. Mifepristone (RU 486) induces parturition in primiparous beef heifers and reduces incidence of dystocia. Journal of Animal Science 1995;73:3421‐6. - PubMed
Dudley 1996
    1. Dudley DJ, Branch DW, Edwin SS, Mitchell MD. Induction of preterm birth in mice by RU486. Biology of Reproduction 1996;55:992‐5. - PubMed
Fairley 2005
    1. Fairley TE, MacKenzie M, Owen P, MacKenzie F. Management of late intrauterine death using a combination of mifepristone and misoprostol‐‐experience of two regimens. European Journal of Obstetrics & Gynecology and Reproductive Biology 2005;118(1):28‐31. - PubMed
Fang 1997
    1. Fang X, Wong S, Mitchell BF. Effects of RU486 on estrogen, progesterone, oxytocin, and their receptors in the rat uterus during late gestation. Endocrinology 1997;138:2763‐8. - PubMed
French 2001
    1. French L. Oral prostaglandin E2 for induction of labour. Cochrane Database of Systematic Reviews 2001, Issue 2. [DOI: 10.1002/14651858.CD003098] - DOI - PMC - PubMed
Haluska 1994
    1. Hluska GJ, Kaler CA, Cook MJ, Novy MJ. Prostaglandin production during spontaneous labor and after treatment with RU486 in pregnant rhesus macaques. Biology of Reproduction 1994;51:760‐5. - PubMed
Hapangama 2003
    1. Hapangama DK. Mifepristone: the multifaceted antihormone. Journal of Drug Evaluation 2003;1(5):149‐75.
Heikinheimo 1997
    1. Heikinheimo O. Clinical pharmacokinetics of mifepristone. Clinical Pharmacokinetics 1997;33:7‐17. - PubMed
Higgins 2008
    1. Higgins JPT, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.1 [updated September 2008].The Cochrane Collaboration, 2008. Available from www.cochrane‐handbook.org.
Hofmeyr 2003a
    1. Hofmeyr GJ, Gülmezoglu AM. Vaginal misoprostol for cervical ripening and induction of labour. Cochrane Database of Systematic Reviews 2003, Issue 1. [DOI: 10.1002/14651858.CD000941] - DOI - PubMed
Hofmeyr 2003b
    1. Hofmeyr GJ, Alfirevic Z, Kelly T, Kavanagh J, Thomas J, Brocklehurst P, et al. Methods for cervical ripening and labour induction in late pregnancy: generic protocol. Cochrane Database of Systematic Reviews 2003, Issue 2. [DOI: 10.1002/14651858.CD002074] - DOI
Howarth 2001
    1. Howarth GR, Botha DJ. Amniotomy plus intravenous oxytocin for induction of labour. Cochrane Database of Systematic Reviews 2001, Issue 3. [DOI: 10.1002/14651858.CD003250] - DOI - PMC - PubMed
Hutton 2001
    1. Hutton EK, Mozurkewich EL. Extra‐amniotic prostaglandin for induction of labour. Cochrane Database of Systematic Reviews 2001, Issue 2. [DOI: 10.1002/14651858.CD003092] - DOI - PMC - PubMed
Kavanagh 2001
    1. Kavanagh J, Kelly AJ, Thomas J. Sexual intercourse for cervical ripening and induction of labour. Cochrane Database of Systematic Reviews 2001, Issue 2. [DOI: 10.1002/14651858.CD003093] - DOI - PMC - PubMed
Kavanagh 2005
    1. Kavanagh J, Kelly AJ, Thomas J. Breast stimulation for cervical ripening and induction of labour. Cochrane Database of Systematic Reviews 2005, Issue 3. [DOI: 10.1002/14651858.CD003392.pub2] - DOI - PMC - PubMed
Kavanagh 2006a
    1. Kavanagh J, Kelly AJ, Thomas J. Hyaluronidase for cervical ripening and induction of labour. Cochrane Database of Systematic Reviews 2006, Issue 2. [DOI: 10.1002/14651858.CD003097.pub2] - DOI - PMC - PubMed
Kavanagh 2006b
    1. Kavanagh J, Kelly AJ, Thomas J. Corticosteroids for cervical ripening and induction of labour. Cochrane Database of Systematic Reviews 2006, Issue 2. [DOI: 10.1002/14651858.CD003100.pub2] - DOI - PMC - PubMed
Kelly 2001a
    1. Kelly AJ, Kavanagh J, Thomas J. Castor oil, bath and/or enema for cervical priming and induction of labour. Cochrane Database of Systematic Reviews 2001, Issue 2. [DOI: 10.1002/14651858.CD003099] - DOI - PubMed
Kelly 2001b
    1. Kelly AJ, Tan BP. Intravenous oxytocin alone for cervical ripening and induction of labour. Cochrane Database of Systematic Reviews 2001, Issue 3. [DOI: 10.1002/14651858.CD003246] - DOI - PubMed
Kelly 2001c
    1. Kelly AJ, Kavanagh J, Thomas J. Relaxin for cervical ripening and induction of labour. Cochrane Database of Systematic Reviews 2001, Issue 2. [DOI: 10.1002/14651858.CD003103] - DOI - PMC - PubMed
Kelly 2003
    1. Kelly AJ, Kavanagh J, Thomas J. Vaginal prostaglandin (PGE2 and PGF2a) for induction of labour at term. Cochrane Database of Systematic Reviews 2003, Issue 4. [DOI: 10.1002/14651858.CD003101] - DOI - PubMed
Kelly 2008a
    1. Kelly AJ, Kavanagh J. Nitric oxide donors for cervical ripening and induction of labour. Cochrane Database of Systematic Reviews 2008, Issue 1. [DOI: 10.1002/14651858.CD006901] - DOI - PubMed
Luckas 2000
    1. Luckas M, Bricker L. Intravenous prostaglandin for induction of labour. Cochrane Database of Systematic Reviews 2000, Issue 4. [DOI: 10.1002/14651858.CD002864] - DOI - PMC - PubMed
Muzonzini 2004
    1. Muzonzini G, Hofmeyr GJ. Buccal or sublingual misoprostol for cervical ripening and induction of labour. Cochrane Database of Systematic Reviews 2004, Issue 4. [DOI: 10.1002/14651858.CD004221.pub2] - DOI - PMC - PubMed
Neilson 2000
    1. Neilson JP. Mifepristone for induction of labour. Cochrane Database of Systematic Reviews 2000, Issue 4. [DOI: 10.1002/14651858.CD002865] - DOI - PubMed
RevMan 2008 [Computer program]
    1. The Cochrane Collaboration. Review Manager (RevMan). Version 5.0. Copenhagen, The Nordic Cochrane Centre: The Cochrane Collaboration, 2008.
Smith 2003
    1. Smith CA. Homoeopathy for induction of labour. Cochrane Database of Systematic Reviews 2003, Issue 4. [DOI: 10.1002/14651858.CD003399] - DOI - PubMed
Smith 2004
    1. Smith CA, Crowther CA. Acupuncture for induction of labour. Cochrane Database of Systematic Reviews 2004, Issue 1. [DOI: 10.1002/14651858.CD002962.pub2] - DOI - PubMed
Thomas 2001
    1. Thomas J, Kelly AJ, Kavanagh J. Oestrogens alone or with amniotomy for cervical ripening or induction of labour. Cochrane Database of Systematic Reviews 2001, Issue 4. [DOI: 10.1002/14651858.CD003393] - DOI - PMC - PubMed
Van Look 1995
    1. Look PF, Hertzen H. Clinical uses of antiprogestogens. Human Reproduction Update 1995;1:19‐34. - PubMed

LinkOut - more resources