Author(s)

Anna Thorbiornson¹, Tomislav Vladic², Ylva Vladic Stjernholm^2*

¹Medical Educational Programme in Gynecology and Obstetrics, Karolinska University Hospital and Karolinska Institute, Stockholm, Sweden.
²Department of Women’s and Children’s Health, Karolinska University Hospital, Stockholm, Sweden.

Objective: To compare labor induction with transcervical catheter to oral misoprostol treatment in primiparous women and women with an unripe cervix, who are at high risk for unsuccessful labor induction. Study Design: A retrospective study was carried out in a university hospital in Sweden. Primary outcomes were vaginal birth within 24 hours and the cesarean section rate. Secondary outcomes were the induction to vaginal delivery interval, chorioamnionitis and neonatal asphyxia. Results: Vaginal birth within 24 hours was obtained more frequently after catheter compared with misoprostol in primiparous women (p < 0.001) and women with Bishop scores 3 - 4 (p < 0.001), but not in women with Bishop scores 0 - 2 (p = 0.07). The cesarean section rates were comparable in all groups (p > 0.05). The induction to vaginal delivery interval was 8 - 12 hours shorter after catheter (p < 0.001). The rates of chorioamnionitis and newborns with an Apgar score < 7 at 5 min were comparable (p > 0.05). Conclusion: Labor induction with transcervical catheter resulted in a higher rate of vaginal birth within 24 hours and an 8 - 12 hour shorter induction to vaginal delivery interval compared to treatment with oral misoprostol. This was obtained without increasing the rates of cesarean section, chorioamnionitis or neonatal asphyxia.

Cervical Ripening, Transcervical Catheter, Oral Misoprostol, Vaginal Birth, Cesarean Section

Thorbiornson, A. , Vladic, T. and Stjernholm, Y. (2015) Labor Induction with Transcervical Catheter versus Oral Misoprostol in Primiparous Women and Women with an Unripe Cervix. Open Journal of Obstetrics and Gynecology, 5, 819-826. doi: 10.4236/ojog.2015.514116.