Cervical ripening options produce similar results. (Three Techniques Compared).

SAN FRANCESCO -- Three techniques for prelabor cervical ripening--intravaginal misoprostol, intracervical Foley catheter, or both-worked equally well in a prospective, randomized study of 146 women.

There were no significant differences between groups in the rates of vaginal delivery; neonatal outcomes; or time from labor induction to delivery, Dr. Wilson H. Huang reported.

The study included women at two institutions undergoing labor induction for delivery of singletons with reassuring fetal heart rate readings. All of the women had an unfavorable cervix, defined as a Bishop score of 6 or less, and were randomized to one of three treatment groups, she said at the annual meeting of the Society for Maternal-Fetal Medicine.

The first group received 25 [micro]g of misoprostol in the posterior fornix every 3 hours for cervical ripening until the onset of labor or until they received a maximum of six doses (150 [micro]g) in 24 hours. Labor was defined as more than three contractions in a 10-minute period.

If membranes ruptured during the 24-hour trial of misoprostol without labor starting, the women received no more misoprostol but got oxytocin through an infusion pump to induce labor at the discretion of their physicians.

In the second group, clinicians inserted a 24 French Foley catheter into the cervix, inflated a bulb with 30 cc of normal saline, and left it in place for up to 12 hours or until the catheter was spontaneously expelled. If membranes ruptured during that time without labor, they withdrew the catheter and started oxytocin to induce labor. Women with intact membranes whose catheters were expelled or removed after 12 hours started oxytocin if they were not yet in labor.

Investigators employed both strategies for cervical ripening in the third group.