The objective of this study was to compare the efficacy and safety of intracervical
Foley catheter with concurrent use of oxytocin versus vaginal misoprostol for labor
induction in nulliparous women. Nulliparous women with Bishop score <6 who presented
for labor induction were randomized to either 25 μg vaginal misoprostol every 4 hours
followed by oxytocin, if indicated, or intracervical Foley catheter with simultaneous
use of oxytocin. Among the 162 patients enrolled, 79 (49%) received misoprostol and
83 (51%) received Foley/oxytocin. We were unable to demonstrate a statistically significant
difference between the misoprostol group and Foley/oxytocin group in the incidence
of cesarean delivery (35% versus 29%; p = 0.37). The induction-to-delivery time was significantly shorter in the Foley/oxytocin
group (18 versus 24 hours; p < 0.01). No differences in intrapartum complications, neonatal outcomes, or maternal
morbidity were found. When compared with vaginal misoprostol, intracervical Foley
catheter combined with oxytocin has a similar efficacy and safety profile for labor
induction in nulliparous women. Foley/oxytocin results in a shorter induction-to-vaginal
delivery time compared with misoprostol.
KEYWORDS
Induction - misoprostol - Foley catheter
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