title: Comparing vaginal misoprostol versus Foley catheter plus vaginal isosorbide mononitrate for labor induction.
abstract: OBJECTIVE
  To compare the effectiveness and safety of intra-cervical Foley catheter combined with intra-vaginal isosorbide mononitrate (IMN) versus intra-vaginal misoprostol for cervical ripening and labor induction in pregnant women with unripe cervices.
  
  
  METHODS
  Open-labeled randomized controlled trial in Cairo university hospital, Cairo, Egypt during 2012-2014. Three hundred and ninety-five pregnant women at term or post-term with an indication for labor induction and unripe cervix were included in the study. The subjects were randomly divided into two groups. Vaginal misoprostol was used in group 1 (n = 197) and intra-cervical Foley catheter plus vaginal IMN in group 2 (n = 198). Our main outcome measure was cesarean section rate.
  
  
  RESULTS
  Among the 395 included patients there were significantly lower duration of induction of labor (p < 0.001) in group 1with lower cesarean section rates [22.8% in group 1versus 33.3% in group 2; RR 0.7 (0.6-0.9), (p = 0.020)]. Whereas the uterine hyperstimulation (p < 0.001) was significantly higher in group 1. There were no significant differences between both groups as regard patients' demographic characteristics.
  
  
  CONCLUSIONS
  Vaginal misoprostol is more effective but less safe than Foley catheter combined with vaginal IMN for induction of labor in term and post-term pregnancy.
authors.affiliation: a Department of Obstetrics and Gynecology, Faculty of Medicine , Cairo University , Cairo , Egypt.
authors.forename: Waleed
authors.initials: W
authors.lastname: El-Khayat
authors.affiliation: a Department of Obstetrics and Gynecology, Faculty of Medicine , Cairo University , Cairo , Egypt.
authors.forename: Heba
authors.initials: H
authors.lastname: Alelaiw
authors.affiliation: a Department of Obstetrics and Gynecology, Faculty of Medicine , Cairo University , Cairo , Egypt.
authors.forename: Abdallah
authors.initials: A
authors.lastname: El-kateb
authors.affiliation: a Department of Obstetrics and Gynecology, Faculty of Medicine , Cairo University , Cairo , Egypt.
authors.forename: Ali
authors.initials: A
authors.lastname: Elsemary
mesh_terms: D000282:Administration, Intravaginal; D000328:Adult; D020070:Cervical Ripening / Q000187:drug effects*; D005260:Female; D006801:Humans; D007548:Isosorbide Dinitrate / Q000008:administration & dosage / Q000031:analogs & derivatives*; D007751:Labor, Induced / Q000379:methods*; D016595:Misoprostol / Q000008:administration & dosage*; D020030:Nitric Oxide Donors / Q000008:administration & dosage*; D010120:Oxytocics; D011247:Pregnancy; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D020030:Nitric Oxide Donors; D010120:Oxytocics; D016595:Misoprostol; D007548:Isosorbide Dinitrate; C030397:isosorbide-5-mononitrate
keywords: Cervical ripening; foley catheter; isosorbide mononitrate; labor induction; misoprostol