ABSTRACT
We compared labor induced by vaginal misoprostol versus a supracervical Foley catheter
and oral misoprostol. Singleton pregnancies at ≥ 24 weeks' gestation were randomized
to either an initial 25-μg dose of intravaginal misoprostol, followed by 50-μg intravaginal
doses at 3- to 6-hour intervals, or a supracervical Foley balloon and 100 μg of oral
misoprostol at 4- to 6-hour intervals. Primary outcome was time from induction to
delivery. One hundred twenty-six women were randomized to vaginal misoprostol alone
(group I) and 106 women to Foley and oral misoprostol (group II). The groups were
similar in age, weight, gestational age, parity, indication for induction of labor,
and oxytocin use. Cesarean delivery rates at 37% and cesarean indications were similar
(p = 0.25). The time from induction to delivery in group II (12.9 hours) was significantly
shorter than that in group I (17.8 hours, p < 0.001). Uterine tachysystole occurred less often in the vaginal misoprostol group
(21% versus 39%, p = 0.015). Compared with vaginal misoprostol, delivery within 24 hours was significantly
more likely with a Foley balloon and oral misoprostol. The use of terbutaline and
peripartum outcomes were similar in the two groups.
KEYWORDS
Misoprostol - labor induction - prostaglandins
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James B HillM.D.
Department of Obstetrics & Gynecology, Naval Medical Center Portsmouth
620 John Paul Jones Circle Portsmouth, VA 23708-2197
Email: james.hill4@med.navy.mil
