Abstract:

Background: Induction of labor is a common practice in obstetrics, with rates ranging from 9.5% to 33.7% of pregnancies annually, as indicated by current studies. In cases of an unripe cervix, the likelihood of a successful vaginal birth is reduced. Consequently, cervical ripening before initiating uterine contractions is recommended. The assessment of cervical ripening is typically done using the Bishop score. When the Bishop score falls below 6, the use of a cervical ripening agent is advised before labor induction. Non- pharmacologic methods for cervical ripening and labor induction have included intracervical Catheter induction (intra cervical catheterization), while pharmacologic agents such as Misoprostol are also used for the same purpose. When the Bishop score is favorable, oxytocin is the preferred pharmacologic agent {preferred for what?} cervical ripening or labour induction.

Methods: This cross-sectional study design will recruit 150 patients admitted and scheduled for labor induction. The primary objective is to evaluate associated factors with cervical ripening outcomes using either intra-cervical Catheterization or Misoprostol.

Results: The analytical crosssectional study at BMC involved 150 induced pregnant women, divided into two groups: 75 using Misoprostol and 75 using Foley Catheter (FC). The primary indication for induction was postdates (53%), followed by pre-eclampsia (27%). Vaginal delivery rates were higher in the Misoprostol group (82.7%) compared to the FC group (72.0%), while cesarean section rates were lower in the Misoprostol group (17.3%) compared to the FC group (28.0%), with Misoprostol being associated with a lower likelihood of cesarean delivery (OR = 0.2). There were no significant differences in maternal complications or NICU admissions between the groups, though postpartum hemorrhage was slightly higher in the FC group (5.3% vs. 2.7%).


Conclusion: The study demonstrates that Misoprostol is more effective than the Foley Catheter in achieving successful cervical ripening and promoting vaginal delivery within a specified time frame. Factors such as reduced labor duration and lower cesarean section rates support the preference for Misoprostol over Foley Catheter in cervical ripening protocols.