Abstract: Objectives: To compare the proportion of women delivering within 24 hours of concurrent transcervical Foley catheter and vaginal misoprostol versus vaginal misoprostol alone for induction of labor.
Methods: Two hundred and forty-two women (34 to 41 weeks of gestation, singleton live fetus in cephalic presentation, modified Bishops score ≤6 and intact membranes) were randomized into two groups of 121 each. Transcervical Foley catheter inflated with 50 cc saline (kept for maximum of 12 hours) was used along with 25 µg of misoprostol in combined group. Second group received misoprostol alone. Both groups received 25 µg of misoprostol per vaginum every 4 hours (maximum 5 doses). Women not in active labor after 5 doses of misoprostol were considered as failed induction and further management was done according to hospital protocol.
Results: Induction to delivery time was shorter by 1.75 hours in combined group. There was 9% increase in rate of delivery in 24 hours with concurrent Foley and misoprostol. The first stage and active stage of labor was shorter by 2 hours and fewer doses of misoprostol were required in concurrent group. Maternal and neonatal complications were comparable in the two groups.
Conclusions: The concurrent method (mechanical + pharmacological) conferred significant benefits like shorter time to enter active labor, shorter duration of first stage of labor and induction to delivery interval, resulting in an average of two hours shorter stay for a woman in labor without affecting maternal and neonatal outcomes.
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