Cervical ripening and induction of labor with misoprostol, dinoprostone gel, and a Foley catheter: a randomized trial of 3 techniques.
OBJECTIVE
The purpose of this study was to compare the efficacy of 3 different techniques of cervical ripening and induction.


METHODS
Patients who required cervical ripening and induction were randomized to one of 3 groups: (1) supracervical Foley catheter and intravaginal dinoprostone gel, (2) supracervical Foley catheter and 100 microg oral doses of misoprostol, or (3) serial 100-microg oral doses of misoprostol. Intravenous oxytocin was administered when a protraction disorder of labor was identified.


RESULTS
There were 339 women randomized. There was no significant difference in the time from first intervention to delivery in the 3 groups (P =.546). In each group, a similar percentage of women required oxytocin (P =.103). The rates of cesarean delivery were equivalent among the groups (P =.722). Rates of tachysystole were high but statistically equivalent among the 3 groups. There were no significant differences in Apgar scores or umbilical artery pH.


CONCLUSIONS
Oral 100 microg serial doses of misoprostol, with or without the use of a supracervical Foley catheter, were equivalent to the use of a supracervical Foley catheter and serial 4-mg doses of dinoprostone gel for cervical ripening and the induction of labor.
Barrilleaux
P Scott
PS
Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, USA.
Bofill
James A
JA
Terrone
Dom A
DA
Magann
Everett F
EF
May
Warren L
WL
Morrison
John C
JC
D000328:Adult; D002404:Catheterization; D020070:Cervical Ripening; D002585:Cesarean Section / Q000706:statistics & numerical data; D036861:Delivery, Obstetric; D015232:Dinoprostone / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D005782:Gels; D006801:Humans; D007751:Labor, Induced / Q000379:methods*; D016595:Misoprostol / Q000009:adverse effects / Q000627:therapeutic use*; D010120:Oxytocics / Q000009:adverse effects / Q000627:therapeutic use*; D010121:Oxytocin / Q000627:therapeutic use; D011247:Pregnancy; D016019:Survival Analysis; D013614:Tachycardia, Paroxysmal / Q000139:chemically induced; D013997:Time Factors
D005782:Gels; D010120:Oxytocics; D016595:Misoprostol; D010121:Oxytocin; D015232:Dinoprostone