Low dose intravaginal misoprostol versus intracervical balloon catheter for pre-induction cervical ripening

Background:The efficacy and safety of low dose misoprostol as a ripening agent compared to the widely used balloon catheter in developing countries is undetermined. Objective:To compare the safety and efficacy of a low dose intravaginal misoprostol and intracervical Foley's catheter for cervical ripening. Design:A prospective randomized controlled trial. Setting:Zonal General Hospital, Kwale, Nigeria from June 1, 1998 to May 30, 2001. Methods:Candidates for pre-induction cervical ripening were randomized to receive either 250 mcg of intravaginal misoprostol every four hours (n = 60) or intracervical Foley's catheter (n = 61). Main outcome measures:Failure to achieve cervical ripening within 24 hours, need for augmentation, maternal and foetal complications. Results: Failure to achieve cervical ripening within two hours was reduced with misoprostol (Relative Risk [RR] 0.63, 95% Confidence Interval [CI] 0.43 - 0.92). Need for oxytocin augmentation was less in the misoprostol group (RR 0.76, 95% CI 0.64 to 0.91). No significant differences existed in rates for uterine hyperstimulation, Caesarean section, maternal and neonatal morbidity. Conclusion:Intravaginal misoprostol in a low dose was compared to intracervical balloon catheter for pre-induction ripening of the cervix. (East African Medical Journal: 2003 80(2): 91-94