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Misoprostol versus Foley catheter insertion for induction of labor in pregnancies affected by fetal growth restriction
Author(s) -
Chavakula Pearlin R.,
Benjamin Santosh J.,
Abraham Anuja,
Londhe Vaibhav,
Jeyaseelan Visalakshi,
Mathews Jiji E.
Publication year - 2015
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2014.11.018
Subject(s) - medicine , misoprostol , foley catheter , obstetrics , cardiotocography , labor induction , intrauterine growth restriction , vaginal delivery , gynecology , catheter , oxytocin , pregnancy , fetus , surgery , abortion , genetics , biology
Objective To compare 25 μg of vaginal misoprostol with a Foley catheter for induction of labor (IOL) for fetal growth restriction. Methods A randomized controlled trial was conducted in a tertiary center in South India. Women with fetal growth restriction (n = 100) were randomized to be induced with three doses of vaginal misoprostol (25 μg) every 6 hours or with an intracervical Foley catheter, inserted 12 hours before rupture of membranes, and oxytocin if needed. The primary outcome was uterine tachysystole with fetal cardiotocography abnormalities. Secondary outcomes pertained to effectiveness, complications, and patient satisfaction. Results One woman in the misoprostol group and none in the Foley catheter group had uterine tachysystole. The duration of labor from IOL to delivery was similar in both groups ( P = 0.416). More women in the misoprostol group had a vaginal delivery within 12 hours (26.1% versus 5.6%; P = 0.005). Women induced with misoprostol were less likely to deliver by lower‐segment cesarean delivery (15.2% versus 29.6%; P = 0.168) and to require oxytocin augmentation (60.9% versus 85.2%; P = 0.007). Complications were few in both group. Conclusion Few women had uterine tachysystole with cardiotocography abnormalities. Vaginal misoprostol at 25 μg was more effective than a Foley catheter for IOL in fetal growth restriction. Clinical Trials Registry India: CTRI/2014/02/004411 .