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Vaginal misoprostol versus intracervical Foley catheter for cervical ripening in postdate primigravid women: a randomized clinical trial

BACKGROUND: Being one of the most common indications of labor induction, postdate pregnancy can lead to serious maternal and fetal complications. In this study we aimed to compare vaginal misoprostol with intracervical Foley catheter (FC) for cervical ripening in postdate primigravid women. METHODS:...

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Autores principales: Abdi, Nazanin, Alavi, Azin, Pakbaz, Forough, Darabi, Hossein
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8317279/
https://www.ncbi.nlm.nih.gov/pubmed/34315413
http://dx.doi.org/10.1186/s12884-021-04011-0
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author Abdi, Nazanin
Alavi, Azin
Pakbaz, Forough
Darabi, Hossein
author_facet Abdi, Nazanin
Alavi, Azin
Pakbaz, Forough
Darabi, Hossein
author_sort Abdi, Nazanin
collection PubMed
description BACKGROUND: Being one of the most common indications of labor induction, postdate pregnancy can lead to serious maternal and fetal complications. In this study we aimed to compare vaginal misoprostol with intracervical Foley catheter (FC) for cervical ripening in postdate primigravid women. METHODS: This randomized clinical trial included 120 primigravid women aged 18–35 years with singleton,  postdate pregnancies, and Bishop score ≤ 4. Participants were randomized into two equal groups. The first group received 25 µg vaginal misoprostol and the second group had an 18 Fr FC inserted into their cervical canal. Labor induction was performed using oxytocin in both groups if progression of labor or true contractions did not occur within 6 h of the interventions. In case of nonreassuring fetal heart rate, fetal distress, placental abruption, or prolonged labor, C-section was performed. RESULTS: The frequency of normal vaginal delivery, Cesarean section, meconium-stained amniotic fluid, and neonatal intensive care unit admission did not differ significantly between groups. Placental abruption and uterine tachysystole occurred more frequently in the misoprostol group (15.0 vs. 1.7%, P = 0.008 and 21.7 vs. 0.0%, P < 0.001, respectively). A significantly higher number of women in the FC group required oxytocin (73.3 vs. 41.7%, P < 0.001). Duration of labor was significantly higher in the FC group (P = 0.001). CONCLUSIONS: Due to the lower rate of placental abruption and uterine tachysystole observed with FC, it appears to be superior to vaginal misoprostol for cervical ripening in postdate primigravid women; however, its longer labor duration and higher oxytocin requirement should be taken into consideration. TRIAL REGISTRATION: Iranian Registry of Clinical Trials, IRCT20181218042033N4. Registered 19/04/2020. Retrospectively registered, https://www.irct.ir/trial/47037
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spelling pubmed-83172792021-07-28 Vaginal misoprostol versus intracervical Foley catheter for cervical ripening in postdate primigravid women: a randomized clinical trial Abdi, Nazanin Alavi, Azin Pakbaz, Forough Darabi, Hossein BMC Pregnancy Childbirth Research BACKGROUND: Being one of the most common indications of labor induction, postdate pregnancy can lead to serious maternal and fetal complications. In this study we aimed to compare vaginal misoprostol with intracervical Foley catheter (FC) for cervical ripening in postdate primigravid women. METHODS: This randomized clinical trial included 120 primigravid women aged 18–35 years with singleton,  postdate pregnancies, and Bishop score ≤ 4. Participants were randomized into two equal groups. The first group received 25 µg vaginal misoprostol and the second group had an 18 Fr FC inserted into their cervical canal. Labor induction was performed using oxytocin in both groups if progression of labor or true contractions did not occur within 6 h of the interventions. In case of nonreassuring fetal heart rate, fetal distress, placental abruption, or prolonged labor, C-section was performed. RESULTS: The frequency of normal vaginal delivery, Cesarean section, meconium-stained amniotic fluid, and neonatal intensive care unit admission did not differ significantly between groups. Placental abruption and uterine tachysystole occurred more frequently in the misoprostol group (15.0 vs. 1.7%, P = 0.008 and 21.7 vs. 0.0%, P < 0.001, respectively). A significantly higher number of women in the FC group required oxytocin (73.3 vs. 41.7%, P < 0.001). Duration of labor was significantly higher in the FC group (P = 0.001). CONCLUSIONS: Due to the lower rate of placental abruption and uterine tachysystole observed with FC, it appears to be superior to vaginal misoprostol for cervical ripening in postdate primigravid women; however, its longer labor duration and higher oxytocin requirement should be taken into consideration. TRIAL REGISTRATION: Iranian Registry of Clinical Trials, IRCT20181218042033N4. Registered 19/04/2020. Retrospectively registered, https://www.irct.ir/trial/47037 BioMed Central 2021-07-27 /pmc/articles/PMC8317279/ /pubmed/34315413 http://dx.doi.org/10.1186/s12884-021-04011-0 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Abdi, Nazanin
Alavi, Azin
Pakbaz, Forough
Darabi, Hossein
Vaginal misoprostol versus intracervical Foley catheter for cervical ripening in postdate primigravid women: a randomized clinical trial
title Vaginal misoprostol versus intracervical Foley catheter for cervical ripening in postdate primigravid women: a randomized clinical trial
title_full Vaginal misoprostol versus intracervical Foley catheter for cervical ripening in postdate primigravid women: a randomized clinical trial
title_fullStr Vaginal misoprostol versus intracervical Foley catheter for cervical ripening in postdate primigravid women: a randomized clinical trial
title_full_unstemmed Vaginal misoprostol versus intracervical Foley catheter for cervical ripening in postdate primigravid women: a randomized clinical trial
title_short Vaginal misoprostol versus intracervical Foley catheter for cervical ripening in postdate primigravid women: a randomized clinical trial
title_sort vaginal misoprostol versus intracervical foley catheter for cervical ripening in postdate primigravid women: a randomized clinical trial
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8317279/
https://www.ncbi.nlm.nih.gov/pubmed/34315413
http://dx.doi.org/10.1186/s12884-021-04011-0
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