title: A randomized comparison of oral misoprostol versus Foley catheter and oxytocin for induction of labor at term.
abstract: OBJECTIVE
  We sought to compare the efficacy and safety of oral misoprostol administered to patients with the efficacy and safety in a control group treated with a Foley catheter and oxytocin for induction of labor.
  
  
  METHODS
  Two hundred patients requiring induction of labor at term with a Bishop score of </=5 were randomized to receive oral misoprostol or a cervical Foley catheter plus oxytocin. Patients in the misoprostol group received 50 microg at 4-hour intervals for a maximum of 6 doses or until an adequate contraction pattern developed. Those in the control group had a Foley catheter inserted in the cervix, whereas oxytocin was administered intravenously by a standard incremental infusion protocol to a maximum dose of 36 mU/min.
  
  
  RESULTS
  In multiparous patients the percentage delivered of their neonates within 24 hours and the median induction-to-delivery times were similar in the 2 groups. In nulliparous patients, however, delivery within 24 hours was significantly less likely in the misoprostol group (53.4% vs 82. 5%; P <.001), and the median induction-to-delivery time was longer (23.3 hours vs 17.2 hours; P <.01). There were no differences in the incidence of meconium, chorioamnionitis, low Apgar scores, or cesarean delivery. The incidence of hyperstimulation was higher in the oxytocin-Foley group (4.1% vs 13.1%; P =.02).
  
  
  CONCLUSIONS
  Oral misoprostol is as effective as oxytocin-Foley catheter for inducing labor in multiparous women. Misoprostol appears less efficacious in nulliparous patients.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Tennessee, Memphis 38103, USA.
authors.forename: D
authors.initials: D
authors.lastname: Abramovici
authors.forename: S
authors.initials: S
authors.lastname: Goldwasser
authors.forename: B C
authors.initials: BC
authors.lastname: Mabie
authors.forename: B M
authors.initials: BM
authors.lastname: Mercer
authors.forename: R
authors.initials: R
authors.lastname: Goldwasser
authors.forename: B M
authors.initials: BM
authors.lastname: Sibai
mesh_terms: D000284:Administration, Oral; D000328:Adult; D002404:Catheterization; D020070:Cervical Ripening / Q000187:drug effects; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007751:Labor, Induced; D016595:Misoprostol / Q000008:administration & dosage* / Q000009:adverse effects*; D007744:Obstetric Labor Complications / Q000188:drug therapy; D010120:Oxytocics / Q000008:administration & dosage* / Q000009:adverse effects*; D010121:Oxytocin / Q000008:administration & dosage*; D010298:Parity; D011247:Pregnancy; D013577:Syndrome; D013997:Time Factors; D014590:Uterine Contraction / Q000187:drug effects
chemical_list: D010120:Oxytocics; D016595:Misoprostol; D010121:Oxytocin