Comparative study of induction of labour with dinoprostone gel versus mechanical dilatation in unfavorable cervix (low Bishops Score)

Gayatri Mathuriya, Sharad Pratap Singh Kushwaha, Shweta Pradhan


Background: Induction of labour is a common procedure in obstetrics, occurring in upto 30% of pregnancies. Objective of present study was to compare the efficacy of double balloon transcervical catheter to that of a PG vaginal insert among women undergoing labour induction in terms of singleton pregnancies of both nulliparous and multiparous women with an unfavorable cervix.

Methods: Patient admitted for induction of labour were randomized to receive intravaginal dinoprostone or intracervical Foley’s catheter. Patient not entering active labour and having rupture membranes or arrest of dilatation received IV oxytocin.

Results: 150 patients received dinoprostone gel (group A) and 150 patients received Foleys catheter no.18 (group B). The mean time until cervix ripening was less in group A group (0.0001-p value). The mean time until vaginal delivery was less in the Group A group (p value-0.010) among vaginal deliveries more patients in the Group A group delivered within 24 hours (0.0001-P value.). There was significant differences in cesarean delivery rates (8% vs 20.66%, P value-0.0001, sig). Oxytocins is required in both groups (73.33% vs. 78.66%).

Conclusions: Group A was associated with more rapid cervical ripening, shorten induction to vaginal delivery interval and greater no. of vaginal deliveries within 24 hours.


Cervix ripening, Foleys catheter, Labour induction, PG

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Laws PJ, Sullivan EA. Australia’s Mothers and Babies 2002. AIHW Cat. No. PER 28. Sydney: AIHW National Perinatal Statistics Unit. (Perinatal Statistics Series No. 15) 2004.

National Collaborating Centre for Women’s and Children’s Health. Induction of labour. London, UK: RCOG Press;2008.

Joan Crane, St Jhon’s NF, Line L, Gregory JR. Induction of labour at term. J Obstet Gynecol Can. 2001;23:717-28.

McEwan AS. Induction of labour. Obstet Gynecol Reprod Medicine. 2008;18:1-6

Vellekoop J , Vrouenraets FP, van der Steeg JW, Mol BW, Roumen FJ. Indications and results of labour induction in nulliparous women: An interview among obstetricians, residents and clinical midwives. Eur J Obstet Gynecol Reprod Biol. 2009;146:156-9.

Nicole W, Karjane, Ellen L, Brock, Scott W. Induction of labour using a Foley Balloon, With and Without Extra –Amniotic Saline Infusion. Obstet Gynecol. 2006;107:234-9.

Ghanaei MM, Sharami H, Asgari A. Labour induction in nulliparous women: a randomized controlled trial of foley catheter with Extra –Amniotic saline infusion. J Turkish-German Gynecol Assoc. 2009;10:71-5.

Niromanesh S, Mosavi-Jarrahi A, Samkhaniani F. Intracervical Foley catheter balloon vs. prostaglandin in preinduction cervical ripening. Int J Gynecol Obstet. 2003;81:23-7.

Rouben D, Arias F. A randomized trial of extra-amniotic saline infusion plus intracervical foley catheter ballon versus prostaglandin E2 vaginal gel for ripening the cervix and inducing labour in patient with unfavorable cervixes. Obstet Gynecol. 1993;82:290-4.

Venagalil SR, Guinn DA, Olabi NF, Burd L, Owen J. A randomized trial of misoprrostol and extraamniotic saline infusion for cervical ripening and labour induction. Obstet Gynecol. 1998;91:774-9.

Barrilleaux PS, Bofill JA, Terrone DA, Magann EF, May WL, Morrison JC. Cervical ripening and induction of labour with misoprostol, dinoprostone gel, and a Foley catheter:A randomized trial of 3 techniques. Am J Obstet Gynecol. 2002;186;1124-9.

Culver J, Strauss RA, Brody S, Dorman K, Timlin S, Mc Mahon MJ. A randomized trial comparing vaginal misoprostol versus Foley Catheter with concurrent oxytocin for labour induction in nulliparous women. Am J Perinatol. 2004;21:139-46.

Guinn DA, Goepfert AR, Christine M, Owen J, Hauth JC. Extra-amniotic saline, laminaria, or prostaglandin E2 gel for labour induction with unfavourable cervix: a randomized controlled trial. Obstet Gynecol. 2002;187:847-52.

Mullin PM, House M, Paul RH, Wing DA. A comparison of vaginally adminie stered misoprsotol with extra-amniotic saline solution infusion for cervical ripening and labour induction. Am J Obstet Gynecol. 2002;187:847-52.

Charanchakul B, Herabutya Y. Randomised comparison of glycerol trinitrate and prostaglandin E2 for cervical ripening at term. Obstet Gynecol. 2000;96:549-53.

Herbutya YO, Prasertsawat P, Pokpirom J.A comparison of intravaginal misoprostol and intracervical prostaglandin E2 gel for ripening of unfavourable cervix and labour induction. J Obstet Gynecol Res. 1997;23:369-74.

Bugalho A, Bique C, Machungo F, Faundes. A Low dose vaginal misoprostol for induction of labour with a live fetus. Int J Gynecol Obstet. 1995;49:1149-55.

Wing DA, Rahall A, Jones MM, Goodwin TM, Paul RH. Misoprostol: an effective agent for cervical ripening and labour induction. Am J Obstet Gynecol. 1995:172: 1811-6.

Rayburn WF. Pre-induction cervical ripening: basis and methods of current practice. Obstet Gynecol Surv. 2002;57:683-692.

Zafarghandi AS, Baghaii NZ. Foley catheter cervical ripening with extraamniotic infusion of saline or corticosteroids: a double-blind, randomized controlled study. Acta Medica Iranica. 2004;42(5):338-42.