Cervical ripening: a randomized comparison between intravaginal misoprostol and an intracervical balloon catheter combined with intravaginal dinoprostone.
OBJECTIVE
Our purpose was to compare the efficacy of intravaginal misoprostol and intracervical Foley catheter/intravaginal dinoprostone for cervical ripening.


METHODS
Patients admitted for induction of labor were randomized to receive intravaginal misoprostol 25 microg every 4 hours or intracervical Foley catheter/intravaginal dinoprostone 4 mg every 4 hours. Patients not entering active labor and having ruptured membranes or arrest of dilatation received intravenous oxytocin.


RESULTS
Sixty-five patients received Foley catheter/dinoprostone gel and 62 patients received misoprostol. The mean time until cervical ripening was less in the catheter/gel group (7.5 +/- 3.4 vs 12.0 +/- 5.9 hours, p < 0.01). The mean time until vaginal delivery was less in the catheter/gel group (17.4 +/- 6.9 vs 21.2 +/- 7.5 hours, p = 0.004). Among vaginal deliveries, more patients in the catheter/gel group delivered within 24 hours (90% vs 69%, p = 0.013).


CONCLUSIONS
Intracervical Foley catheter/intravaginal dinoprostone was associated with more rapid cervical ripening, shorter induction to vaginal delivery interval, and greater number of vaginal deliveries within 24 hours.
Perry
K G
KG
Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, USA.
Larmon
J E
JE
May
W L
WL
Robinette
L G
LG
Martin
R W
RW
D000282:Administration, Intravaginal; D000328:Adult; D002404:Catheterization; D002584:Cervix Uteri / Q000187:drug effects* / Q000502:physiology*; D036861:Delivery, Obstetric / Q000379:methods; D015232:Dinoprostone / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007751:Labor, Induced; D016595:Misoprostol / Q000009:adverse effects / Q000627:therapeutic use*; D010120:Oxytocics / Q000009:adverse effects / Q000627:therapeutic use*; D011247:Pregnancy; D011256:Pregnancy Outcome; D013997:Time Factors
D010120:Oxytocics; D016595:Misoprostol; D015232:Dinoprostone