Induction of labour with foley catheter is better alternative to misoprostol

Abstract

AIM- The aim of this study was to compare the efficacy of induction of labour with Foley balloon inflation to 60ml with sublingual misoprostol. MATERIALS AND METHODS -This randomised controlled trial (n= 320) was performed on women with singleton pregnancy with cephalic presentation and unfavourable cervix admitted in RG Kar Medical College during the period of July 2011 to June 2012. In Foley group, labour was induced by placing No. 20 transcervical Foley catheter and inflating the balloon to 60 ml along with intravenous oxytocin. In Misoprostol group, sublingual misoprostol was used, 25 mcg every 4 hours to a maximum of 5 doses until adequate uterine contractions. Intravenous oxytocin was administered in patients with protraction or arrest disorders. RESULTS -The two groups were similar in demographic characteristics, indication for induction, pre-induction Bishop score, maternal and fetal complications. Time from induction to delivery was significantly shorter in Foley catheter group compared to misoprostol group(15.19+2.83 vs 16.16+3.35 hr, p<0.05). Mean post induction Bishop Score at 6 hours and 12 hours was significantly higher in Foley catheter group compared to misoprostol group (5.98+1.46 vs 4.95+1.33 and 8.45+1.5 vs 7.12+1.6, p<0.05). CONCLUSION - labour induction with Foley catheter is a safe and effective method of with less induction to delivery time. It avoids the side effects of misoprostol like nausea, vomiting, diarrhoea, fever shivering as well as uterine complications like tachysystole, rupture, and fetal death. CLINICAL SIGNIFICANCE –Induction of labour by Transcervical foley is a better alternative to misoprostol and should me more widely used.