n South African Journal of Obstetrics and Gynaecology - Labour induction at term - a randomised trial comparing Foley catheter plus titrated oral misoprostol solution, titrated oral misoprostol solution alone, and dinoprostone

Volume 9, Issue 2
  • ISSN : 0038-2329
  • E-ISSN: 2078-5135



&lt;I&gt;Objectives.&lt;/I&gt; To compare three methods of labour induction. &lt;br&gt;&lt;I&gt;Design.&lt;/I&gt; Randomised controlled trial. <br><I>Setting</I>. Academic hospitals in Johannesburg, South Africa. <br><I>Subjects</I>. Women with intact membranes due for induction of labour. &lt;br&gt;&lt;I&gt;Method.&lt;/I&gt; Randomised, sealed opaque envelopes were used to allocate women to labour induction with extra-amniotic Foley catheter / titrated oral misoprostol solution (N = 174), titrated oral misoprostol solution alone (N = 176), or vaginal dinoprostone (N = 176). Misoprostol was dissolved in water and 20 - 40 g was given 2-hourly. <br><I>Outcome measures.&lt;/I&gt; These were failure to deliver vaginally within 24 hours, additional measures for induction or augmentation of labour, analgesia, and maternal and fetal complications. &lt;br&gt;&lt;I&gt;Results.&lt;/I&gt; In the Foley catheter group, misoprostol was required in all but 1 case. Failure to deliver vaginally within 24 hours was similar for the three groups (79/174 v. 70/176 v. 70/176 respectively). Labour augmentation, caesarean section and instrumental delivery were used somewhat more frequently in the Foley / misoprostol group than in the misoprostol alone group, but these differences were not statistically significant. More analgesia was used in the Foley catheter / misoprostol group than in the misoprostol group (64/172 v. 46/175). Sideeffects and neonatal complications were similar for the three groups. &lt;br&gt;&lt;I&gt;Conclusions.&lt;/I&gt; Use of extra-amniotic Foley catheter placement showed no measurable benefits over the use of oral misoprostol alone, or vaginal dinoprostone.

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