title: Foley catheter versus intra-vaginal misoprostol for induction of labor in post-term gestations.
abstract: OBJECTIVE
  To investigate whether a fluid filled intra-uterine extra-amniotic Foley catheter is an effective alternative to vaginal misoprostol in inducing labor in primigravid women with post-term gestations.
  
  
  METHODS
  A prospective quasi-randomized controlled trial was designed and 100 primigravid women with post-term gestations were enrolled and equally allocated into two groups. A fluid filled intra-uterine extra-amniotic Foley catheter was inserted in women of group I. Women in group II received 25 microgram misoprostol vaginally every 4 h. Artificial rupture of membranes was performed for all women when their cervices reached 3-4 cm dilatation followed by oxytocin infusion if needed. The main primary outcome parameter was the induction to delivery interval. Results were tabulated and statistically analyzed.
  
  
  RESULTS
  No significant difference was noted in any of the demographic data between both groups. The induction to delivery interval was shorter in the Foley group (897.36 ± 116.0 vs. 960.98 ± 94.18 min; P = 0.003). There were 34 cases which needed oxytocin augmentation in group I compared to 11 cases in group II (P < 0.01). Abnormal uterine activity occurred in three cases in the misoprostol group, but none in the Foley group. Ominous fetal heart rate was noted in one case in group I but three in group II.
  
  
  CONCLUSIONS
  Fluid filled Foley catheter seems to be superior to 25 μg vaginal misoprostol regimen, when used to induce labor in primigravidae with post-term gestations with the advantage of having a shorter induction delivery interval, but more need for oxytocin augmentation.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Menofyia University, Shibin Elkom, Egypt. kandeelcando@yahoo.com
authors.forename: Mohamed
authors.initials: M
authors.lastname: Kandil
authors.forename: Mohamed
authors.initials: M
authors.lastname: Emarh
authors.forename: Tarek
authors.initials: T
authors.lastname: Sayyed
authors.forename: Alaa
authors.initials: A
authors.lastname: Masood
mesh_terms: D000282:Administration, Intravaginal; D000328:Adult; D005260:Female; D006340:Heart Rate, Fetal / Q000187:drug effects / Q000502:physiology; D006801:Humans; D007751:Labor, Induced / Q000379:methods*; D016595:Misoprostol / Q000627:therapeutic use*; D010120:Oxytocics / Q000627:therapeutic use*; D010121:Oxytocin / Q000627:therapeutic use; D011247:Pregnancy; D014546:Urinary Catheterization; D055815:Young Adult
chemical_list: D010120:Oxytocics; D016595:Misoprostol; D010121:Oxytocin