Rajat Kumar Ray, Sunita Samal

BACKGROUND Uterine leiomyomata are the commonest benign gynaecological tumours occurring in up to 25 per cent of women in reproductive age. There are various surgical and medical modalities of treatment of fibroids which are found to be very effective. Recent evidence suggests that progesterone is essential for maintenance and growth of uterine leiomyoma and that oestrogen is required only for upregulation of progesterone receptors. Mifepristone (RU 486) is a progesterone receptor modulator with primarily antagonistic properties. Dissimilarity in claims has been reported in various studies using different protocols. The aim of the present study was to evaluate the efficacy of treatment with mifepristone 25 mg daily for 3 months for reduction in size of fibroids. MATERIALS AND METHODS Ultrasound was done to confirm the diagnosis of leiomyomas as well as to ascertain number, location and volume of myomas. Volume of each myoma was calculated. Mifepristone was administered in a dose of 25 mg/day orally till 3 months. Patients were followed up every month till 3 months. Repeat ultrasound was done to assess the size of fibroids. Settings and Design- Prospective Cohort Study. Statistical Analysis- Statistical analysis was done using MedCalc software. Proportions were analysed using a chi-square test. Unpaired student’s t-test was used for mean values. Results were expressed as mean & standard deviation. P<0.05 was considered as significant. RESULTS The age range of patients was 24 to 45 years. There was a significant reduction in the volume of the fibroids after 3 months (38.54±42.42 cc to 20.38±25.42 cc). In 9 women, the fibroid volume did not change, but there was symptomatic relief. CONCLUSION Mifepristone in a dose of 25 mg daily for 3 months can be used as an effective drug in the medical management of fibroids. Mifepristone can be a good choice especially in perimenopausal women in whom myomas would regress after menopause and patients who want to avoid surgery.