title: Misoprostol versus Foley catheter insertion for induction of labor in pregnancies affected by fetal growth restriction.
abstract: OBJECTIVE
  To compare 25μg of vaginal misoprostol with a Foley catheter for induction of labor (IOL) for fetal growth restriction.
  
  
  METHODS
  A randomized controlled trial was conducted in a tertiary center in South India. Women with fetal growth restriction (n=100) were randomized to be induced with three doses of vaginal misoprostol (25μg) every 6hours or with an intracervical Foley catheter, inserted 12hours before rupture of membranes, and oxytocin if needed. The primary outcome was uterine tachysystole with fetal cardiotocography abnormalities. Secondary outcomes pertained to effectiveness, complications, and patient satisfaction.
  
  
  RESULTS
  One woman in the misoprostol group and none in the Foley catheter group had uterine tachysystole. The duration of labor from IOL to delivery was similar in both groups (P=0.416). More women in the misoprostol group had a vaginal delivery within 12hours (26.1% versus 5.6%; P=0.005). Women induced with misoprostol were less likely to deliver by lower-segment cesarean delivery (15.2% versus 29.6%; P=0.168) and to require oxytocin augmentation (60.9% versus 85.2%; P=0.007). Complications were few in both group.
  
  
  CONCLUSIONS
  Few women had uterine tachysystole with cardiotocography abnormalities. Vaginal misoprostol at 25μg was more effective than a Foley catheter for IOL in fetal growth restriction. Clinical Trials Registry India:CTRI/2014/02/004411.
authors: Department of Obstetrics and Gynecology, Christian Medical College, Vellore, Tamil Nadu, India.
authors: Pearlin R
authors: PR
authors: Chavakula
authors: Department of Obstetrics and Gynecology, Christian Medical College, Vellore, Tamil Nadu, India.
authors: Santosh J
authors: SJ
authors: Benjamin
authors: Department of Obstetrics and Gynecology, Christian Medical College, Vellore, Tamil Nadu, India.
authors: Anuja
authors: A
authors: Abraham
authors: Department of Obstetrics and Gynecology, Christian Medical College, Vellore, Tamil Nadu, India.
authors: Vaibhav
authors: V
authors: Londhe
authors: Department of Biostatistics, Christian Medical College, Vellore, Tamil Nadu, India.
authors: Visalakshi
authors: V
authors: Jeyaseelan
authors: Department of Obstetrics and Gynecology, Christian Medical College, Vellore, Tamil Nadu, India. Electronic address: og5@cmcvellore.ac.in.
authors: Jiji E
authors: JE
authors: Mathews
mesh_terms: D000282:Administration, Intravaginal; D000328:Adult; D015148:Cardiotocography; D002584:Cervix Uteri; D004334:Drug Administration Schedule; D005260:Female; D005317:Fetal Growth Retardation / Q000628:therapy*; D006801:Humans; D007194:India; D007751:Labor, Induced / Q000379:methods*; D007743:Labor, Obstetric / Q000187:drug effects; D016595:Misoprostol / Q000008:administration & dosage*; D010120:Oxytocics / Q000008:administration & dosage*; D011247:Pregnancy; D014546:Urinary Catheterization / Q000379:methods*
chemical_list: D010120:Oxytocics; D016595:Misoprostol
keywords: Cesarean delivery; Duration of labor; Fetal growth restriction; Foley catheter; Induction of labor; Misoprostol; Oxytocin; Uterine tachysystole