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Original Research Article Introduction: Induction of labour is widely carried over the world in cases where continuation of pregnancy is hazardous to mother or fetus. Varieties of techniques are available for induction of labour. Although there are many proper methods for cervical ripening, there exists no agreement on the choice of best and most proper method of labour induction in cases with unripe cervix. Among these methods cervical foley catheter and vaginal misoprostol (PGE1) are more commonly used for labour induction and cervical ripening. The efficacy and safety of low dose misoprostol as a ripening agent compared to the widely used balloon catheter in developing countries is undetermined. So, this study was carried out to see the safety and efficacy of intravaginal misoprostol and intra cervical Foley‟s catheter for cervical ripening. Material & Methods: This randomized clinical trial was performed on 100 primigravida women who were admitted in department of obstetrics and gynaecology unit of Rajshahi medical college and hospital during a time period of July 2012 to December 2012 with various indication for induction of labour volunteering to participate were included in the study. These women were randomly divided in to two groups. Misoprostol group (including 50 patients) and Foley‟s catheter group (including 50 patients). For the first group 25 microgram vaginal misoprostol tablet was administered every 4 hours up to maximum of 6 doses. For the second group Foley‟s catheter 18F, inflated with 50cc distilled water was placed through the internal os of the cervix. Results: In this study 50 patients where intravaginal misoprostol tablet was used for cervical ripening where compared with 50 patients were cervical ripening was done by using intracervical and extra-amniotic Foley‟s catheter. Two groups were similar in the view of demographic characteristics, indication for labour induction, caesarian indications, maternal and fetal outcomes. Out of 100 patients 41(82%) women in misoprostol group and 42(82%) in Foley‟s catheter group were delivered vaginally. Augmentation by oxytocin drip was required in 9(18%) and 9(18%) case in two groups. Artificial rupture membrane required 18(36%) and 19(38%) cases and both oxytocin drip and ARM required in 13(26%) and 11(22%) cases in misoprostol and Foley‟s catheter group respectively. Comparison of mean differences of inductionlabour pain interval, induction-full dilatation interval, induction-delivery interval between the groups showed no significant difference, but the relationship between Bishop‟s score and induction-full dilatation interval of the cervix showed a negative ( r= -0.963, -0.879 respectively and highly significant p <0.008, <0.050 in both groups). That is increase in Bishop‟s score reduce the induction-full dilatation interval. The mean difference of Apgar score at 1 minute was significantly significant (P<0.05) between two groups but at 5 minutes was not statistically significant (P >0.05). Conclusion: From this study it was found that the safety and efficacy of Foley‟s catheter is comparable to misoprostol. In addition, Foley‟s catheter is free from side effects of misoprostol like vomiting and hyperstimulation. Therefore, we feel that Foley‟s catheter can be used instead of misoprostol safely and effectively for cervical ripening especially in the developing countries.

scholars journal of applied medical sciences

“Effectiveness of Intravaginal Foley’s Catheter and Intravaginal Misoprostol Use on Cervical Ripening in Term Pregnancy: A randomized comparative study in a tertiary hospital of Bangladesh”