title: Progress of labor in women induced with misoprostol versus the Foley catheter.
abstract: OBJECTIVE
  To estimate and compare the duration and progress of labor in women induced with misoprostol vs Foley catheter plus oxytocin.
  
  
  METHODS
  We performed a retrospective cohort study of labor progress among 617 consecutive term pregnancies induced with misoprostol (n = 503) or Foley catheter plus oxytocin (n = 114) who completed the first stage of labor. Labor duration and progress in the entire cohort, and stratified by parity, were compared in multivariable interval-censored regression models adjusting for maternal obesity and birthweight. Repeated-measures analysis with 9th degree polynomial modeling was used to construct average labor curves.
  
  
  RESULTS
  Total duration of labor was not significantly different in women induced with misoprostol compared with the Foley catheter (median duration from 1 to 10 cm: 12 vs 14.2 hours, P = .19). Progress from 1 to 4 cm was more rapid with the Foley catheter (median: 3.4 vs 5.6 hours, P < .01), although progress from 4 to 10 cm was slower (median: 6.3 vs 3.6 hours, P < .01). Labor curves demonstrated transition from latent to active labor at about 4 cm cervical dilatation with misoprostol and at 6 cm for the Foley catheter. Similar general patterns were noted for nulliparous and multiparous women, except for a shorter duration of labor with the Foley catheter among multiparous women.
  
  
  CONCLUSIONS
  Induction of labor with the Foley catheter is associated with more rapid initial cervical dilation, but transition to active labor occurs later compared with misoprostol. These differences should be considered in the management of induced labor.
authors: Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO, USA.
authors: Methodius G
authors: MG
authors: Tuuli
authors: Mary B
authors: MB
authors: Keegan
authors: Anthony O
authors: AO
authors: Odibo
authors: Kimberly
authors: K
authors: Roehl
authors: George A
authors: GA
authors: Macones
authors: Alison G
authors: AG
authors: Cahill
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007751:Labor, Induced; D016595:Misoprostol / Q000494:pharmacology*; D011247:Pregnancy; D012189:Retrospective Studies; D014546:Urinary Catheterization
chemical_list: D016595:Misoprostol
keywords: Foley catheter; labor induction; labor progress; misoprostol
references: Obstet Gynecol. 2001 Apr;97(4):603-7
references: 11275035
references: Am J Perinatol. 2004 Apr;21(3):139-46
references: 15085496
references: Obstet Gynecol. 2000 Jun;95(6 Pt 1):917-22
references: 10831992
references: J Obstet Gynaecol. 2005 Aug;25(6):565-8
references: 16234141
references: Obstet Gynecol. 2012 Apr;119(4):732-6
references: 22433336
references: Natl Vital Stat Rep. 2010 Aug 9;58(24):1-85
references: 21254725
references: Obstet Gynecol. 2000 Nov;96(5 Pt 1):671-7
references: 11042299
references: Acta Obstet Gynecol Scand. 2010 Aug;89(8):1045-52
references: 20636243
references: Am J Obstet Gynecol. 2003 Oct;189(4):1031-5
references: 14586350
references: Paediatr Perinat Epidemiol. 2006 Jan;20(1):72-8
references: 16420344
references: Obstet Gynecol. 2005 Apr;105(4):698-704
references: 15802393
references: Am J Obstet Gynecol. 1992 Jun;166(6 Pt 1):1690-6; discussion 1696-7
references: 1615976
references: Obstet Gynecol. 2006 May;107(5):1029-34
references: 16648407
references: Cochrane Database Syst Rev. 2012 Mar 14;(3):CD001233
references: 22419277
references: Obstet Gynecol. 2010 Apr;115(4):705-710
references: 20308828
references: Obstet Gynecol. 2012 Jun;119(6):1113-8
references: 22569121
references: Birth. 2006 Mar;33(1):12-7
references: 16499527