Comparative study of vaginal misoprostol and intra cervical Foley’s catheter for pre-induction cervical ripening at term


  • Meghna Agarwal Junior Resident, Department of Obstetrics and Gynecology, Lata Mangeshkar Hospital, Nagpur, Maharashtra, India
  • Varsha Kose Department of Obstetrics and Gynecology, Lata Mangeshkar Hospital, Nagpur, Maharashtra, India



Cervical ripening, Foleys catheter, Labor induction, Vaginal misoprostol


Background: At times of unfavorable cervix induction of labor with cervical ripening agents were necessary. The present study was done to compare the efficacy and outcome of vaginal misoprostol and Foleys catheter in pregnant women for induction of labor.

Methods: This randomized clinical trial was performed on 10o pregnant women during a time period of December 2014 to November 2016. These women were randomly divided into two groups: Misoprostol (50 patients) and Foley catheter (50 patients). For the first group, 25 mcg vaginal misoprostol was administered every 4 h up to maximum of 3 doses for a period of 12 hours. For the second group, Foley catheter 18 F, was placed through the internal os of the cervix. Data was analyzed using SPSS software 20. p <0.05 was considered statistically significant.

Results: The mean age of the patients in Group 1 was 24.72±2.93 years and Group 2 was 24.12±2.88 years. Pre-induction & post-induction modified Bishop score was significantly higher in Group 1 (Misoprostol) as compared to Group 2 (Foley's catheter) in primigravida and multigravida patients. The difference in the birth weight and Apgar score at 1 min and 5 min between the two groups was statistically not significant (p>0.05). The rate of vaginal delivery was significantly more in Misoprostol group as compared to Foley’s catheter group (p<0.05). The caesarean section rate was more in Foley’s catheter group as compared to Misoprostol group and the results were statistically significant (p<0.05).

Conclusions: It was concluded that misoprostol decrease the delivery time and increases the vaginal delivery compared to Foleys catheter.


Wolf JP, Sinosich M, Anderson TL, Ulman A, Bauliac EE, Hodgen GD. Progestrene antagonist (RU 486) for Cervical Dilation, Labor Induction, and Delivery in Monkeys: Effectiveness in Combination with Oxytocin. Am J Obstetrics Gynecol. 1989;160:45-7.

Roudsari FV, Ayati S, Ghasemi M, Mofrad MH, Shakeri MT, Farshidi F, et al. Comparison of Vaginal Misoprostol with Foley Catheter for Cervical Ripening and Induction of Labor. Iran J Pharm Res. 2011;10(1):149-54.

Adeniji AO, Olayemi O, Odukogbe AA. Intra-vaginal misoprostol versus transcervical Foley catheter in pre-induction cervical ripening. Int J Gynaecol Obstet. 2006;92:130-2.

Noor N, Ansari M, Manazir Ali S, Parveen S. Foley Catheter versus Vaginal Misoprostol for Labour Induction. Int J Reproductive Med. 2015;(2015): ID 845735.

Mozurkewich E, Chilimigras J, Koepke E, Keeton K, King VJ. Indications for induction of labour: a best-evidence review, BJOG. Int J Obstetrics Gynaecol. 2009;116(5):626-36.

Jagielska I, Kazdepka-Ziemińska A, Janicki R, Fórmaniak J, Walentowicz-Sadłecka M, Grabiec M. Evaluation of the efficacy and safety of Foley catheter pre-induction of labor. Ginekol Pol. 2013;84(3):180-5.

Fareed P, Malik S, Mahajan N, Nazir T, Kawoosa S. Comparative Study of Intra-Cervical Foley Catheter and Vaginal Misoprostol for Pre-Induction Cervical Ripening. Int J Sci Study. 2015;3(4):40-3.

Oliveira MV, Oberst PV, Leite GK, Aguemi A, Kenj G, Leme VD, et al. Cervical Foley catheter versus vaginal misoprostol for cervical ripening and induction of labor: A randomized clinical trial. Rev Bras Ginecol Obstet. 2010;32:346-51.

Chavakula PR, Benjamin SJ, Abraham A, Londhe V, Jeyaseelan V, Mathews JE. Misoprostol versus Foley catheter insertion for induction of labor in pregnancies affected by fetal growth restriction. Int J Gynaecol Obstet. 2015;129(2):152-5.

Filho OBM, Albuquerque RM, Cecatti JG. A randomized controlled trial comparing vaginal misoprostol versus foley catheter plus oxytocin for labor induction. Acta Obstetricia et Gynecologica Scandinavica. 2010;89(8):1045-52.






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