A randomized comparison of transcervical Foley catheter to intravaginal misoprostol for preinduction cervical ripening

Objective: To compare the efficacy of intravaginal misoprostol tablets with transcervical Foley catheter for preinduction cervical ripening. Methods: Pregnant women who presented for induction of labor with unfavorab le cervices (Bishop score less than 6) were assigned randomly to intravagin al misoprostol (50 mug tablet every 4 hours for a maximum of six doses) or 30-mL Foley catheter placed transcervically with maintenance of traction. Results: Among 111 women, 53 were allocated to misoprostol and 58 to Foley bulb. Contractile abnormalities were more frequent in the misoprostol group (20.4%) than the Foley group (0%) (P < .001). No statistically significant differences were noted between groups in change in Bishop score, preinduct ion cervical ripening times, and total induction times. There were no stati stically significant differences in mode of delivery or adverse neonatal ou tcomes. Uterine rupture occurred in one woman with two previous cesarean de liveries in the misoprostol group. Conclusion: Intravaginal misoprostol and transcervical Foley catheter are e quivalent for cervical ripening. Uterine contractile abnormalities and meco nium passage are more common with misoprostol. <(c)> 2001 by The American C ollege of Obstetricians and Gynecologists.