ROLE OF LOW DOSE MIFEPRISTONE IN THE TREATMENT OF SYMPTOMATIC FIBROID UTERUS: A DOUBLE CONTROL RANDOMIZED CONTROL TRIAL
Journal of Evolution of Medical and Dental Sciences
Fibroids are the most common benign tumors of the uterus primarily affecting the reproductive age group presenting with symptoms like menorrhagia, dysmenorrhea, pelvic pain and pressure symptoms and frequently infertility. Hysterectomy and myomectomy have been the surgical options for the management of symptomatic fibroids. Procedures like uterine artery embolization and thermal balloon ablation are expensive procedures and still not available in most centers. Various drug therapies like Gn RH
... erapies like Gn RH analogues, danazol, etc. have been tried to reduce symptoms. The anti-progestin, mifepristone (RU 486) has been studied since the past few decades for its effect on reduction of symptoms of fibroid uterus. AIMS: The effect of low dose mifepristone given for three months was assessed on symptomatic fibroids over six months. SETTINGS AND DESIGN: This randomized control study here was done on 100 patients who presented with symptomatic fibroid to the department of obstetrics and gynecology at RIMS, Ranchi over a period of eighteen months. MATERIAL AND METHODS: The study group was given mifepristone 20 mg daily for three months and the control group was given a placebo. Both these groups were followed up for six months and assessment of symptoms like menorrhagia, dysmenorrhea, pelvic pain was done. Serial assessment of fibroid volume and uterine volume was done on ultrasound. RESULTS AND CONCLUSION: The data was analysed using chi square test. We found a significant decrease in the symptoms like severe menorrhagia, pelvic pain in the study group as compared to the control group. Also there was a significant reduction in size of the fibroid in the study group. Thus mifepristone was found to be effective in reducing symptoms caused by fibroid with minimal associated side effects.