Skip to main content
SpringerLink
Log in

Sequential Versus Concurrent Use of Vaginal Misoprostol Plus Foley Catheter for Induction of Labor: A Randomized Clinical Trial

  • Original Article
  • Published:
The Journal of Obstetrics and Gynecology of India Aims and scope Submit manuscript

Abstract

Background

To compare between the sequential and concurrent use of vaginal misoprostol plus Foley catheter for labor induction.

Methods

This single-center, non-blinded randomized study was conducted at the department of Obstetrics and Gynecology, Faculty of medicine, Zagazig University. A total of 160 women with full term singleton pregnancy, cephalic presentation and bishop score ≤ 6 were randomized for labor induction with either concurrent or sequential use of vaginal misoprostol plus Foley catheter (80 cases in each group). The primary outcome measured was induction-to-delivery interval and secondary outcomes mesaured were vaginal delivery within 24 h, number of doses needed to induce labor, need of oxytocin for augmentation of labor, cesarean section rate, maternal or neonatal complications.

Results

The mean induction-to-delivery interval was 22.33 ± 13.28 h versus 18.45 ± 14.34 h (p = 0.041) in sequential and concurrent group, respectively. The percentage of women who completed vaginal delivery within 24 h was 51% versus 61% (p = 0.046) in sequential and concurrent group, respectively. Other maternal and neonatal outcomes were similar in both groups

Conclusion

Concurrent use of vaginal misoprostol plus Foley catheter for labor induction was associated with shorter induction-to delivery interval compared to sequential use, and it increases the rate of vaginal delivery in the first 24 h.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Geeta K, Swamy MD. Current methods of labor induction. Semin Perinatol. 2012;36(5):348–52.

    Article  Google Scholar 

  2. Induction of Labor. Royal College of Obstetricians. and Gynaecologists. 2008: Available: http://www.rcog.org.uk. Accessed 2012 June 26.

  3. Mozurkewich E, Chilimigras J, Koepke K, Keeton K, King VJ. Indications for induction of labor: a best-evidence review. BJOG. 2009;116(5):626–36.

    Article  PubMed  CAS  Google Scholar 

  4. Gulmezoglu AM, Crowther CA, Middleton P, Healy E. Induction of labor for improving birth outcomes for women at or beyond term. Cochrane Database Syst Rev 2012; CD004945. doi:10.1002/14651858.CD004945.pub3.

  5. Jozwiak M, Bloemenkamp KW, Kelly AJ, Mol BW, Irion O, Boulvain M. Mechanical methods for induction of labour. Cochrane Database Syst Rev. 2012;3:333.

    Google Scholar 

  6. Kehl S, Ehard A, Berlit S, Spaich S, Sutterlin M, Siemer J. Combination of misoprostol and mechanical dilation for induction of labor: a randomized controlled trial. Eur J Obstet Gynecol Reprod Biol. 2011;159:315–9.

    Article  PubMed  CAS  Google Scholar 

  7. Cromi A, Ghezzi F, Uccella S, Agosti M, Serati M, Marchitelli G, et al. A randomized trial of preinduction cervical ripening: dinoprostone vaginal insert versus double-balloon catheter. Am J Obstet Gynecol. 2012;207:125-e1.

    Article  CAS  Google Scholar 

  8. Adeniyi AA, Odukogbe AA, Olayemi A, Oladokun O, Adeniji AO, Aimakhu CO, et al. Randomization of two dosing regimens of vaginal misoprostol for cervical ripening and labor induction in a low resource setting. Niger J Clin Pract. 2014;17:287–91.

    Article  PubMed  CAS  Google Scholar 

  9. Hill JB, Thigpen BD, Bofill JA, Magann E, Moore LE, Martin JN Jr. A randomized clinical trial comparing vaginal misoprostol versus cervical Foley plus oral misoprostol for cervical ripening and labor induction. Am J Perinatol. 2009;26:33–8.

    Article  PubMed  Google Scholar 

  10. Lanka S, Surapaneni T, Nirmalan PK. Concurrent use of Foley catheter and misoprostol for induction of labor: a randomized clinical trial of efficacy and safety. J Obstet Gynaecol Res. 2014;40:1527–33.

    Article  PubMed  CAS  Google Scholar 

  11. Ande AB, Ezeanochie CM, Olagbuji NB. Induction of labor in prolonged pregnancy with unfavorable cervix: comparison of sequential intracervical Foley catheter-intravaginal misoprostol and intravaginal misoprostol alone. Arch Gynecol Obstet. 2012;285:967–71.

    Article  PubMed  Google Scholar 

  12. Carbone JF, Tuuli MG, Fogertey PJ, Roehl KA, Macones GA. Combination of Foley bulb and vaginal misoprostol compared with vaginal misoprostol alone for cervical ripening and labor induction: a randomized controlled trial. Obstet Gynecol. 2013;121:247–52.

    Article  PubMed  Google Scholar 

  13. Hussein M. A comparison between vaginal misoprostol and a combination of misoprostol and Foley catheter for cervical ripening and labor induction in early third Trimester pregnancy. Am J Obstet Gynecol. 2012;206:147.

    Article  Google Scholar 

  14. Levine LD, Downes KL, Elovitz MA, Parry S, Sammel MD, Srinivas SK. Mechanical and pharmacologic methods of labor induction: a randomized controlled trial. Obstet Gynecol. 2016;6:1357–64.

    Article  CAS  Google Scholar 

  15. Kehl S, Ziegler J, Schleussner E, Tuschy B, Berlit S, Kirscht J, et al. Sequential use of double-balloon catheter and oral misoprostol versus oral misoprostol alone for induction of labor at term (CRB plus trial): a multicentre, open-label randomized controlled trial. BJOG. 2015;122:129–36.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Faculty of Medicine, Zagazig University, Zagazig, Egypt

    Ibrahim Abd Elgafor El Sharkwy, Elsayed Hamdy Noureldin, Ekramy Abd Elmoneim Mohamed & Sherine Attia Shazly

Authors
  1. Ibrahim Abd Elgafor El Sharkwy
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Elsayed Hamdy Noureldin
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ekramy Abd Elmoneim Mohamed
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sherine Attia Shazly
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ibrahim Abd Elgafor El Sharkwy.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Ibrahim Abd Elgafor el Sharkwy (MD) is Assistant Professor of Faculty of Medicine, Zagazig University, Zagazig, Egypt.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

El Sharkwy, I.A., Noureldin, E.H., Mohamed, E.A.E. et al. Sequential Versus Concurrent Use of Vaginal Misoprostol Plus Foley Catheter for Induction of Labor: A Randomized Clinical Trial. J Obstet Gynecol India 68, 408–413 (2018). https://doi.org/10.1007/s13224-017-1059-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13224-017-1059-3

Keywords

Search

Navigation