Comparative study of pharmacological and combined pharmaco-mechanical method of induction of labour: a randomised study

Anshu Kumari, Mahantappa A. Chiniwar, Sharada B. Menasinkai


Background: Comparative study of Pharmacological and Pharmaco- Mechanical method of induction of labour- A Randomised study. The objective of the study was to compare efficacy of pharmacological and combined pharmaco-mechanical method of induction of labour.

Methods: A study was conducted in the department of Obstetrics and gynaecology, Adichunchanagiri Institute of Medical Sciences and Research Centre for a period of 18 months. 200 pregnant women requiring induction of labour were included in the study.  In group 1 Dinoprostone 0.5 mg gel was inserted into cervical canal. In group 2 Foley’s catheter No 18 F was inserted within the cervix. The balloon of the catheter was filled with 30 ml normal saline and at the same time Dinoprostone 0.5 mg gel was inserted into posterior vaginal fornix. The Excel and SPSS (SPSS Inc, Chicago V 18.5) software packages were used for data entry and analysis. The results were averaged (mean ± Std Deviation) for each parameter for continuous data in tables.

Results: Mean induction to active phase interval in group 1 was 8.43±4.11 hrs, in group 26.82±3.01 hrs (p =0.001). The rate of vaginal delivery in group 1 and group 2 was 55% and 66% respectively, difference was statistically significant (p=0.026).

Conclusions: Synchronous use of intracervical Foley’s catheter and Dinoprostone 0.5 mg resulted in a shorter time for progress to active phase and also shortened induction to delivery interval as compared to Dinoprostone 0.5 mg alone. Higher risk of caesarean delivery was associated with single method as compared to combined methods.



Caesarean delivery, Induction of labour, IUGR

Full Text:



Mathuriya G, Kushwaha S, Pradhan S. Comparative study of induction of labour with dinoprostone gel versus mechanical dilatation in unfavorable cervix (low Bishops Score). International J Reproduction, Contraception, Obstetrics and Gynecol. 2017;6(10):4363-6.

Noor N, Ansari M, Ali SM, Parveen S. Foley catheter versus vaginal misoprostol for labour induction. International journal of reproductive medicine. 2015;2015.

Nazneen S, Sultana F, Nahaer K. Intravaginal Mesoprostal Versus Transcervical Foley’s catheter for Pre-induction cervical ripening and their outcome – A Comparative study. Bangladesh J of Obstet and Gynaecol. 2012;27(2):72-8.

Levine LD, Downes KL, Elovitz MA, Parry S, Sammel MD, Srinivas SK. Mechanical and Pharmacologic Methods of Labor induction: A Randomized controlled Trial. Obstet Gynaecol 2016; 128(6):1357-64.

Roudsari FV, Ayati S, Ghasemi M, Mofrad MH, Shakeri MT, Farshidi F, Shahabian M. Comparison of vaginal misoprostol with foley catheter for cervical ripening and induction of labor. Iranian journal of pharmaceutical research: IJPR. 2011;10(1):149.

Indira G, Latha V, Narayanamma L. Comparative study of induction of labour with Foley. s catheter inflated to 30 ml versus 60 ml. J Clinic Sci Res. 2016;5:153-9.

Murmu S, Dwivedi C. A comparative study of intracervical Foley’s catheter and intracervical PGE2 gel for preinduction cervical ripening. IJRCOG. 2018;7(8):3122-5.

Shashi P, Bala A, Sinha M, Goel JK. A Comparative study of intracervical Foley’s catheter with oxytocin and vaginal misoprostal for induction of labour. IJRCOG. 2020;9(9):3660-4.

Garg R, Vardhan S, Singh S, Singh R. Foley Catheter with vaginal prostaglandin E2 gel versus vaginal prostaglandin E 2 gel alone for induction of labour: a randomized controlled trial. IJRCOG. 2018; 7(5):1893-6.

Kenneth G, Perry Jr, J Flaine Larman, Warren L May, Lynd G, Robinette R N, BSN and Rick W Martin. Cervical ripening: A Randomised comparison between intracervical balloon catheter combined with intravaginal dinoprostone. American Journal of Obst and Gynaecol. 1998;178(9):1333- 40.

Chowdhary A, Bagga R, Kalra J, Jain V, Saha SC, Kumar P. Comparison of intracervical Foley’s catheter used alone or combined with a single dose of dinoprostone gel for cervical ripening: a randomised study. J Obst and Gynaecology. 2019;39(4):461-7.

Chung JH, Huang WH, Rumney PJ, Garite TJ, Nageotte MP. A prospective randomized controlled trial that compared misoprostol, Foley catheter, and combination misoprostol–Foley catheter for labor induction. American J Obstetrics and Gynecol. 2003;189(4):1031-5.