A randomized comparison of transcervical Foley catheter to intravaginal misoprostol for preinduction cervical ripening.
OBJECTIVE
To compare the efficacy of intravaginal misoprostol tablets with transcervical Foley catheter for preinduction cervical ripening.


METHODS
Pregnant women who presented for induction of labor with unfavorable cervices (Bishop score less than 6) were assigned randomly to intravaginal misoprostol (50 microg tablet every 4 hours for a maximum of six doses) or 30-mL Foley catheter placed transcervically with maintenance of traction.


RESULTS
Among 111 women, 53 were allocated to misoprostol and 58 to Foley bulb. Contractile abnormalities were more frequent in the misoprostol group (20.4%) than the Foley group (0%) (P <.001). No statistically significant differences were noted between groups in change in Bishop score, preinduction cervical ripening times, and total induction times. There were no statistically significant differences in mode of delivery or adverse neonatal outcomes. Uterine rupture occurred in one woman with two previous cesarean deliveries in the misoprostol group.


CONCLUSIONS
Intravaginal misoprostol and transcervical Foley catheter are equivalent for cervical ripening. Uterine contractile abnormalities and meconium passage are more common with misoprostol.
Department of Obstetrics and Gynecology, Christiana Care Health Services, Maternal-Fetal Medicine Division, Newark, Delaware, USA. asciscione@christianacare.org
A C
AC
Sciscione
L
L
Nguyen
J
J
Manley
M
M
Pollock
B
B
Maas
G
G
Colmorgen
D000282:Administration, Intravaginal; D000328:Adult; D002404:Catheterization; D020070:Cervical Ripening / Q000187:drug effects; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D007751:Labor, Induced / Q000379:methods / Q000592:standards; D016595:Misoprostol / Q000008:administration & dosage*; D010120:Oxytocics / Q000008:administration & dosage*; D011247:Pregnancy; D013607:Tablets; D016896:Treatment Outcome; D014590:Uterine Contraction / Q000187:drug effects
D010120:Oxytocics; D013607:Tablets; D016595:Misoprostol