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
REFERENCES
-
1 ACOG Practice Bulletin No. 10: Induction of Labor. American College of Obstetricians and Gynecologists 1999
-
2
Macer J A, Macer C L, Chan L S.
Elective induction versus spontaneous labor: a retrospective study of complications and outcome.
Am J Obstet Gynecol.
1992;
166
1690-1696
-
3
Sherman D J, Frenkel E, Tovbin J, Arieli S, Caspi E, Bukovsky I.
Ripening of the unfavorable cervix with extraamniotic catheter balloon: clinical experience and review.
Obstet Gynecol Surv.
1996;
51
621-627
-
4
Sciscione A C, Nguyen L, Manley J, Pollock M, Maas B, Colmorgen G.
A randomized comparison of transcervical Foley catheter to intravaginal misoprostol for preinduction cervical ripening.
Obstet Gynecol.
2001;
97
603-607
-
5
Vengalil S R, Guinn D A, Olabi N F, Burd L I, Owen J.
A randomized trial of misoprostol and extra-amniotic saline infusion for cervical ripening and labor induction.
Obstet Gynecol.
1998;
91
774-779
-
6
Abramovici D, Goldwasser S, Mabie B C, Mercer B M, Goldwasser R, Sibai B M.
A randomized comparison of oral misoprostol versus Foley catheter and oxytocin for induction of labor at term.
Am J Obstet Gynecol.
1999;
181
1108-1112
-
7 ACOG Committee Opinion No. 248 .American College of Obstetricians and Gynecologists. 2000
-
8
Hofmeyr G J, Gulmezoglu A M, Alfirevic Z.
Misoprostol for induction of labour: a systematic review.
Br J Obstet Gynaecol.
1999;
106
798-803
-
9
Wing D A, Park M R, Paul R H.
A randomized comparison of oral and intravaginal misoprostol for labor induction.
Obstet Gynecol.
2000;
95
905-908
-
10
Bennett K A, Butt K, Crane J M, Hutchens D, Young D C.
A masked randomized comparison of oral and vaginal administration of misoprostol for labor induction.
Obstet Gynecol.
1998;
92
481-486
-
11
Adair C D, Weeks J W, Barrilleaux S, Edwards M, Burlison K, Lewis D F.
Oral or vaginal misoprostol administration for induction of labor: a randomized, double-blind trial.
Obstet Gynecol.
1998;
92
810-813
-
12
Giacalone P L, Targosz V, Laffargue F, Boog G, Faure J M.
Cervical ripening with mifepristone before labor induction: a randomized study.
Obstet Gynecol.
1998;
92
487-492
-
13
Buser D, Mora G, Arias F.
A randomized comparison between misoprostol and dinoprostone for cervical ripening and labor induction in patients with unfavorable cervices.
Obstet Gynecol.
1997;
89
581-585
-
14
Abramovici D, Goldwasser S, Mabie B C, Mercer B M, Goldwasser R, Sibai B M.
A randomized comparison of oral misoprostol versus Foley catheter and oxytocin for induction of labor at term.
Am J Obstet Gynecol.
1999;
181
1108-1112
Robert A StraussM.D.
University of North Carolina
CB# 7516, Chapel Hill, NC 27599-7516
