CERVICAL RIPENING - A RANDOMIZED COMPARISON BETWEEN INTRAVAGINAL MISOPROSTOL AND AN INTRACERVICAL BALLOON CATHETER COMBINED WITH INTRAVAGINAL DINOPROSTONE

OBJECTIVES: Our purpose was to compare the efficacy of intravaginal mi soprostol and intracervical Foley catheter/intravaginal dinoprostone f or cervical ripening. STUDY DESIGN: Patients admitted for induction of labor were randomized to receive intravaginal misoprostol 25 mu g eve ry 4 hours or intracervical Foley catheter/intravaginal dinoprostone 4 mg every 4 hours. Patients not entering active labor and having ruptu red membranes or arrest of dilatation received intravenous oxytocin. R ESULTS: Sixty-five patients received Foley catheter/dinoprostone gel a nd 62 patients received misoprostol. The mean time until cervical ripe ning was less in the catheter/gel group (7.5 +/- 3.4 vs 12.0 +/- 5.9 h ours, p < 0.01). The mean time until vaginal delivery was less in the catheter/gel group (17.4 +/- 6.9 vs 21.2 +/- 7.5 hours, p = 0.004). Am ong vaginal deliveries, more patients in the catheter/gel group delive red within 24 hours (90% vs 69%, p = 0.013). CONCLUSIONS: Intracervica l Foley catheter/intravaginal dinoprostone was associated with more ra pid cervical ripening. shorter induction to vaginal delivery interval, and greater number of vaginal deliveries within 24 hours.