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Treatment of Leiomyoma with oral mifepristone in a low resource setting

Snehlata & Sweta Lal*
Department of Obstetrics and Gynecology, SBMH, Hazaribag, Jharkhand, India
Received : 19th June, 2021 ; Revised : 29th July, 2021

Abstract– A common benign tumor of the uterus troubling the women of reproductive age group is fibroids .Primarily it presents with symptoms like menorrhagia, pelvic pain, feeling if heaviness leading to a anemia and discomfort in a women’s life. Many women stay asymptomatic and do not seek treatment. The women seeking treatment are primarily treated with symptomatic management with drugs like NSAIDS, hemostatic agents, hematinics, GnRH analogues, Danazol, progesterone oral, depots and IUDs. Minimal invasive procedures like and thermal balloon ablation and uterine artery embolization are expensive and not readily available.The anti-progestin, mifepristone (RU 486) is being now used and studied since the past few decades for its effect on reduction of symptoms of fibroid uterus. This study aims to assess the effect of low dose mifepristone taken for three months on symptomatic patient’s leiomyoma over six months. This was a randomized control study done on 100 patients who presented with fibroid, with symptoms, to the department of Obstetrics and Gynecology at SBMCH, Hazaribagh over a period of eighteen months. The study group was given mifepristone 25 mg once a day for 3 months and the control group was given a placebo. Symptoms like menorrhagia, dysmenorrhea, pelvic pain were evaluated in both these groups over six months at interval of one month, three month and six months. Fibroid volume and uterine volume were assessed on ultrasound. Data analysis was done using chi square test. Symptoms like severe menorrhagia, pelvic pain decreased significant in the study group in comparison to the control group. A significant reduction fibroid size was found in the study group. Thus mifepristone is effective in reducing symptoms associated with fibroid uterus.

Key words: Leiomyoma, oral mifepristone, menorrhagia, pelvic pain, dysmenorrhea, Obstetrics, Gynecology

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