Mifepristone for induction at term: fewer caesareans across 15 trials

The edition in brief

A meta-analysis of 15 randomised trials (1,874 women at 37 weeks or later) found mifepristone used for labour induction was associated with lower odds of caesarean delivery than the comparator method, 33.1% versus 41.9% (OR 0.67, 95% CI 0.54 to 0.82), with the effect holding in placebo-controlled and high-quality trials. Bishop scores rose faster and less prostaglandin and oxytocin was needed; safety outcomes were sparsely reported. A BJOG narrative review on GLP-1 receptor agonist exposure around conception found no clear signal of harm in observational data but too little evidence to call it safe, and advises individual counselling. A Swedish register model in 8,909 first-time mothers with second- to fourth-degree tears predicted anal incontinence at one year with an AUC of 0.78, the Wexner score at eight weeks being the strongest predictor. A small randomised trial of leuprorelin for severe polycystic liver disease stopped early: liver growth was not significantly slowed and adverse events were four times as frequent. The pearl covers what to ask at the eight-week perineal review.