Leiomyoma is the most common benign tumour of uterus occurring in up to 20% of women with maximum incidence between 35-45 years of age leading to menorrhagia, pain and lump in abdomen. Incidence increases with age during the reproductive years such that cases occur in 20% to 50% of women older than 30 years. By extrapolation of findings from a prospective histopathology study of 100 consecutive total hysterectomy specimens, the prevalence of uterine fibroids in the general female population may be as high as 80% and is unchanged by menopausal status.
Aim of the Study
1. To find the effectiveness of Mifepristone in the medical management of uterine leiomyomas.
2. To compare the dose response effect in the form of assessing the change in symptomatic profile and regression in volume of the fibroids. The present study compares the effect of 25 mg and 50 mg Mifepristone (administered once weekly for 6 months).
Materials and Methods: The present study was carried out as a prospective randomized controlled trial comparing the dose response effects of 25 mg and 50 mg weekly administrations of Mifepristone for 6 months. 100 patients satisfying the inclusion criteria were selected for the study. Mifepristone is available as 200 mg tablet (25 mg= 1/8th of the tablet & 50 mg = 1/4th of the tablet).
Results: Myoma volume (6 months) groups table depicts the classification of subjects by myoma volume at 6 months. It is evident from the result that 86.00% subjects were in the ≤ 100 cm3 group followed by 14.00% subjects in 101-150 cm3 group in MIF 25 group. Similarly in MIF 50 group 100.00% subjects were in the ≤ 100 cm3 group (p= <0.0001, unpaired t test)
Conclusion: When symptomatic profile and regression in volume of the fibroids were matched, the following conclusions was observed in MIF 50 treatment compared to MIF 25 treatment
• Better reduction in menstrual blood loss
• Higher reduction in pain Enhanced reduction in myoma volume.