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Subject Area

Internal Medicine

Article Type

Original Study

Abstract

Background and objective Potential advantages of mechanical methods, compared with pharmacological methods, may include simplicity of preservation, lower cost, and reduction of the adverse effects. The objective of this study was to compare the efficacy of combined intracervical Foley catheter and vaginal misoprostol with vaginal misoprostol alone for labor induction. Participants and methods This study was a prospective randomization clinical trial carried out from July 2016 to May 2018 in Benha Health Insurance Hospital. Two hundred pregnant women underwent induction of labor with singleton pregnancies at full-term gestation with (Bishop Score ≤6) by Foley catheter plus vaginal misoprostol (group A, n = 90) or vaginal misoprostol alone (group B, n = 110). Women with fetal malpresentation, multiple pregnancies, spontaneous labor, contraindication to prostaglandins, intrauterine growth restriction, anomalous fetus, and in active phase of labor, or previous cesarean delivery were excluded. The outcome measures were induction-to-delivery time, mode of delivery, oxytocin use, tachysystole with fetal decelerations, complications, neonatal Apgar scores, and neonatal ICU admission. Data were expressed as mean ± SD. Student's t-test was used to compare the mean difference between the two groups, and P value is used to determine the significance of the result. Results The mean induction-to-delivery time was shorter in group A when compared with group B (14.5 ± 4.1 h compared with 18.9 ± 5.2 h, difference 4.4 ± 1.1 h). There were no differences in labor complications or adverse neonatal and maternal outcomes. Conclusion A combined method resulted in a shorter induction-to-delivery time without increasing labor complications.

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