title: Labour induction at term--a randomised trial comparing Foley catheter plus titrated oral misoprostol solution, titrated oral misoprostol solution alone, and dinoprostone.
abstract: OBJECTIVE
  To compare three methods of labour induction.
  
  
  METHODS
  Randomised controlled trial.
  
  
  METHODS
  Academic hospitals in Johannesburg, South Africa.
  
  
  METHODS
  Women with intact membranes due for induction of labour.
  
  
  METHODS
  Randomised, sealed opaque envelopes were used to allocate women to labour induction with extra-amniotic Foley catheter/titrated oral misoprostol solution (N = 174), titrated oral misoprostol solution alone (N = 176), or vaginal dinoprostone (N = 176). Misoprostol was dissolved in water and 20-40 g was given 2-hourly.
  
  
  METHODS
  These were failure to deliver vaginally within 24 hours, additional measures for induction or augmentation of labour, analgesia, and maternal and fetal complications.
  
  
  RESULTS
  In the Foley catheter group, misoprostol was required in all but 1 case. Failure to deliver vaginally within 24 hours was similar for the three groups (79/174 v. 70/176 v. 70/176 respectively). Labour augmentation, caesarean section and instrumental delivery were used somewhat more frequently in the Foley/misoprostol group than in the misoprostol alone group, but these differences were not statistically significant. More analgesia was used in the Foley catheter/misoprostol group than in the misoprostol group (64/172 v. 46/175). Side-effects and neonatal complications were similar for the three groups.
  
  
  CONCLUSIONS
  Use of extra-amniotic Foley catheter placement showed no measurable benefits over the use of oral misoprostol alone, or vaginal dinoprostone.
authors.affiliation: Department of Obstetrics and Gynaecology, Coronation Hospital, University of the Witwatersrand, Johannesburg.
authors.forename: Baron B
authors.initials: BB
authors.lastname: Matonhodze
authors.forename: G Justus
authors.initials: GJ
authors.lastname: Hofmeyr
authors.forename: Jonathan
authors.initials: J
authors.lastname: Levin
mesh_terms: D000282:Administration, Intravaginal; D000284:Administration, Oral; D000328:Adult; D016362:Analgesia, Obstetrical; D002404:Catheterization / Q000379:methods*; D003131:Combined Modality Therapy; D036861:Delivery, Obstetric / Q000379:methods; D003967:Diarrhea / Q000139:chemically induced; D015232:Dinoprostone / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007751:Labor, Induced / Q000379:methods*; D016595:Misoprostol / Q000008:administration & dosage* / Q000009:adverse effects; D007744:Obstetric Labor Complications; D010120:Oxytocics / Q000008:administration & dosage*; D011247:Pregnancy; D011256:Pregnancy Outcome; D017186:Titrimetry; D016896:Treatment Outcome
chemical_list: D010120:Oxytocics; D016595:Misoprostol; D015232:Dinoprostone