TITLE:
Cervical Ripening for Induction of Labor: A Randomized Comparison between Vaginal Misoprostol versus Foley’s Catheter Placement in a Nigeria Tertiary Hospital
AUTHORS:
Matthew Igwe Nwali, Joseph Agboeze, Vitus Okwuchukwu Obi, Arinze C. Ikeotuonye, Ikechukwu Ogwudu Ugadu, Emmanuel Ajuluchukwu Ugwa
KEYWORDS:
Cervical Ripening, Labor Induction, Misoprostol, Balloon Catheter
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.11 No.3,
March
11,
2021
ABSTRACT: Background: Cervical ripening is prerequisite of successful induction of labor.
Vaginal misoprostol and Foley’s catheter placement have been widely used for
this purpose but the data are not always sufficient. We attempted to determine
which (misoprostol versus Foley’s catheter) is more effective/safer in Nigerian
setting. Methods: A randomized controlled trial was performed at Federal
Teaching Hospital Abakaliki, Nigeria, involving 135 term pregnant women requiring cervical ripening and labor
induction. Participants were randomly
allocated to misoprostol versus catheter group. The following were recorded/measured/analyzed: Bishop’s score, age, parity, body mass index,
gestational age, labor duration, indication, oxytocin use, mode of delivery,
and Apgar score. Chi square test and t test were used where appropriate. Results:
At 24 hours, all of misoprostol group were either in labor, had ripe cervix, or
had delivered, whereas 35.4% of catheter group had still unripe cervix (x2 = 29.856, P =
0.0001). Misoprostol group was less likely to require oxytocin infusion (x2 = 52.600, P = 0.0001) and less likely to require cesarean delivery (cesarean: misoprostol versus catheter: 11%
versus 34% (x2 = 9.800, P = 0.001)). Total medical cost for misoprostol was less than that of
catheter (x2 = 14.703, P = 0.0001). Conclusion: 50 μg
vaginal misoprostol, compared with catheter placement,
was more effective, cheaper, and safe as a procedure of cervical ripening before induction of labor.