A comparative study of intracervical foley’s catheter with oxytocin and vaginal misoprostol for induction of labour

Priyanka ., Shashi Bala Arya, Mirdu Sinha, J. K. Goel


Background: Induction of labour implies stimulation of uterine contraction before spontaneous onset of labour with or without ruptured membranes. Aim of this study was to compare the efficacy and safety of intracervical Foley’s catheter with oxytocin and vaginal misoprostol for labour induction at term.

Methods: A total 100 term pregnant women were chosen with bishop score <6 and divided into two groups: Foley’s catheter with oxytocin (Group A) and vaginal misoprostol (Group B). In Group A, a 16 F Foley’s catheter introduced beyond internal os and traction applied every 4 hourly to check for expulsion with simultaneous oxytocin infusion (2 mU/min up to 32 mU/min). In Group B, 25 mcg misoprostol administered every 4 hourly (maximum 6 doses or 150 mcg). Data analysed using SPSS software 20.0. A p value <0.05 was considered statistically significant.

Results: No statistical difference found between demographic variables between two groups. Both primigravida and multigravida had poor pre-induction bishop score in both groups. Foley’s catheter (80%) and misoprostol group (96%) had successful induction and was statistically significant (p<0.05). Foley’s catheter took more time from induction-delivery both in primigravida and post-dated pregnant women. The rate of cesarean in Foley’s catheter group was high (62.5%) including 33% cases with failed induction. Foley’s catheter had less maternal and neonatal complications, less NICU admission as compared to misoprostol (p>0.05).

Conclusions: Misoprostol was found better for successful induction, decreases induction-to-delivery interval and increases vaginal delivery as compared to Foley’s catheter but it needs constant supervision in view of hyperstimulation and tachysystole.


Foley’s catheter, Labour induction, Vaginal misoprostol

Full Text:



Cunningham GF, Leveno KJ, Bloom SL, Hauth JC, Gilstrap L, Wenstorm KD. Normal labour and delivery. Chapter In: William’s Obstetrics. 22nd ed. McGraw Hill; 2005:409-442.

Dasgupta S. Induction of labour: Recent trends. Chapter In: Biswas A, eds. Recent Advances in Obstetrics and Gynaecology, volume 4. New Delhi: JP publications; 2013;4:13-28.

Cunningham GF, Leveno KJ, Bloom SL, Hauth JC, Gilstrap L, Wenstorm KD. Normal labour and delivery. Chapter In: William’s Obstetrics. 22nd ed. McGraw Hill; 2005:412-448.

Cheng YW, Shaffer BL, Caughey AB. The association between persistent occiput posterior position and neonatal outcomes. Obstet Gynecol. 2006;107(4):837-44.

Gupta N, Mishra SL, Jain S. A randomized clinical trial comparing Misoprostol and Dinoprostone for cervical ripening and labour induction. J Obstet Gynecol India. 2006;62(2):149-51.

Chandraharan E, Kumaran SA, editor the management of labour. 2nd ed., Orient Longman Company; 2002:1-22.

Arulkumaran S, Gibb DM, TambyRaja RL, Heng SH, Ratnam SS. Failed induction of labour. Austr NZ J Obstet Gynecol. 1985;25:190-3.

Crane J, Johns NF. SOGC clinical practice guidelines, induction of labour at term. J Obstet Gynaecol Can. 2001;23(8):717-28.

Abbasi N, Danish N, Shakoor F, Parveen Z, Bilal SA. Effectiveness and safety of vaginal Misoprostol for induction of labour in unfavorable cervix in 3rd trimester. J Ayub Med Coll Abbottabad. 2008;20(3):33-5.

Agarwal M, Kose V. Comparative study of vaginal misoprostol and intra cervical Foley’s catheter for pre-induction cervical ripening at term. Int J Reprod Contracept Obstet Gynecol. 2017;6:1283-7.

Noor N, Ansari MS, Ali M. Comparison of vaginal Misoprostol and Foley catheter for cervical ripening. IJSR. 2015;1:475-8.

Promila J, Kaur GB, Bala T. A comparison of vaginal misoprostol versus Foley’s catheter with oxytocin for induction of labor. J Obstet Gynecol India. 2007;57(1):42-7.

Roudsari FV, Ayati S, Ghasemi M, Mofrad MH, Shakeri MT, Farshidi F, et al. Comparison of vaginal misoprostol with Foleys catheter for cervical ripening and induction of labour. Iranian J Pharma Res. 2011;10(1):149-54.

Sujata, Iqbal B, Das V, Agarwal A, Singh R, Evaluation of non-pharmacological method – transcervical foley catheter to intravaginal misoprostol and prostaglandin E2 gel for pre-induction cervical ripening. Biomed Res. 2012;23(2):247-51.

Fareed P, Malik S, Nazir T, Kawoosa S. Comparative study of intra-cervical Foley’s catheter and vaginal misoprostol for pre-induction cervical ripening. Int J Sci Stud. 2015 3(4):40-3.

Sheikher C, Suri N, Kholi U. Comparative evaluation of oral misoprostol, vaginal misoprostol and intracervical Foley’s catheter for induction of labour at term. JK Sci. 2009;11(2):75-7.

Nazeen S, Sultana F, Nahaer K. Intravaginal misoprostol versus transcervical Foley catheter for pre- induction cervical ripening and their outcome: a comparative study. Bangladesh J Obstet Gynaecol. 2012;27(2):72-8.

Masood A. Intracervical foley catheter versus vaginal prostaglandins for induction of labor in women with previous one cesarean section-a pilot study. Obstet Gynecol Int J. 2015;2(5):160-4.