A prospective randomized controlled trial that compared misoprostol, Foley catheter, and combination misoprostol–Foley catheter for labor induction

Objective The purpose of this study was to determine the efficacy of combination intravaginal misoprostol and intracervical Foley catheter for prelabor cervical ripening. Study design A prospective, randomized controlled trial was conducted. Women who were undergoing labor induction, with a singleton gestation ≥28 weeks and an unfavorable cervix (Bishop score ≤6), were assigned to one of three groups: (1) intravaginal misoprostol 25 μg every 3 hours, (2) intracervical 16F Foley catheter, or (3) combination misoprostol–Foley catheter. Results Among 146 patients, 49 patients were assigned to misoprostol, 54 patients were assigned to Foley catheter, and 43 patients were assigned to combination therapy. There was no difference in vaginal delivery rates (misoprostol, 63.3%; Foley, 57.4%; combination, 58.1%; P = .81). There were also no statistically significant differences in the interval between induction to active phase, active phase to delivery, or induction to delivery among the three groups. Conclusion Intravaginal misoprostol and intracervical Foley catheter are comparable for preinduction cervical ripening. The combination of the two methods did not provide additional efficacy.