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Am J Perinatol 2009; 26(1): 033-038
DOI: 10.1055/s-0028-1091396
© Thieme Medical Publishers

A Randomized Clinical Trial Comparing Vaginal Misoprostol versus Cervical Foley Plus Oral Misoprostol for Cervical Ripening and Labor Induction

James B. Hill1 , Brad D. Thigpen2 , James A. Bofill2 , Everett Magann1 , 2 , Lisa E. Moore2 , James N. Martin2  Jr. 
  • 1Portsmouth Naval Medical Center, Portsmouth, Virginia
  • 2Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, Mississippi
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Publication History

Publication Date:
10 October 2008 (online)

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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

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