Cervical ripening and induction of labor with misoprostol, dinoprostone gel, and a Foley catheter: a randomized trial of 3 techniques

Am J Obstet Gynecol. 2002 Jun;186(6):1124-9. doi: 10.1067/mob.2002.123821.

Abstract

Objective: The purpose of this study was to compare the efficacy of 3 different techniques of cervical ripening and induction.

Study design: Patients who required cervical ripening and induction were randomized to one of 3 groups: (1) supracervical Foley catheter and intravaginal dinoprostone gel, (2) supracervical Foley catheter and 100 microg oral doses of misoprostol, or (3) serial 100-microg oral doses of misoprostol. Intravenous oxytocin was administered when a protraction disorder of labor was identified.

Results: There were 339 women randomized. There was no significant difference in the time from first intervention to delivery in the 3 groups (P =.546). In each group, a similar percentage of women required oxytocin (P =.103). The rates of cesarean delivery were equivalent among the groups (P =.722). Rates of tachysystole were high but statistically equivalent among the 3 groups. There were no significant differences in Apgar scores or umbilical artery pH.

Conclusion: Oral 100 microg serial doses of misoprostol, with or without the use of a supracervical Foley catheter, were equivalent to the use of a supracervical Foley catheter and serial 4-mg doses of dinoprostone gel for cervical ripening and the induction of labor.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Catheterization*
  • Cervical Ripening*
  • Cesarean Section / statistics & numerical data
  • Delivery, Obstetric
  • Dinoprostone / adverse effects
  • Dinoprostone / therapeutic use*
  • Female
  • Gels
  • Humans
  • Labor, Induced / methods*
  • Misoprostol / adverse effects
  • Misoprostol / therapeutic use*
  • Oxytocics / adverse effects
  • Oxytocics / therapeutic use*
  • Oxytocin / therapeutic use
  • Pregnancy
  • Survival Analysis
  • Tachycardia, Paroxysmal / chemically induced
  • Time Factors

Substances

  • Gels
  • Oxytocics
  • Misoprostol
  • Oxytocin
  • Dinoprostone