Comparative Study of Intra-Cervical Foley Catheter and Vaginal Misoprostol for Pre-Induction Cervical Ripening

Background: Physical and chemical changes in the uterine cervix and the lower uterine segment, which normally precede the onset of labor are referred to as ripening and seem to be essential to normal labor and delivery. Objective: The aim of this study was to compare the effi cacy of intracervical Foley catheter and 50 mcg vaginal misoprostol in pre-induction cervical ripening. Study Design: A randomized, prospective study was conducted in the Department of Obstetrics and Gynecology, Government Medical College, Srinagar from March 2012 to August 2013. 200 patients at term with a Bishop's score = 3 with various indications for induction were randomly allocated to receive intracervical Foley catheter (100 pts) or 50 mcg vaginal misoprostol (100 pts). After 6 h post-induction bishop's score was noted and labor was augmented if required. Statistical analysis was done using Chi-square test and t-test. Result: The groups were comparable with respect to maternal age, gestational age, indication of induction, and initial bishop's score. Both groups showed signifi cant change in the Bishop's score, 3.8 +/- 1.1 and 3.6 +/- 1.1 for Foley catheter and misoprostol, respectively, P < 0.001; however there was no signifi cant difference between the two groups. 14 cesarean sections (14%) were performed in Group A and 19 (19%) were performed in Group B (not signifi cant). The induction to the delivery interval was 18.1 +/- 3.6 h in Group A and 17.7 +/- 4.1 h in Group B (P = 0.408). Apgar score, birth weights, neonatal intensive care unit admissions, and maternal side effects showed no difference between the two groups. Conclusion: This study shows that both Foley catheter and vaginal misoprostol are equally effective in pre-induction cervical ripening.