Inducing Labor Safely And Effectively

Using misoprostol rather than a catheter to induce labor is not only safer for women with pregnancy complications but also slightly more effective.

AsianScientist (July 5, 2017) – In a major study published in The Lancet, researchers from the University of Liverpool, Gynuity Health Care in New York and the Government Medial College in India concluded that misoprostol tablets are safer and more effective at inducing labor compared with transcervical Foley catheterisation.

As the number of women facing induction increases, it has become urgent to address questions about which methods for inducing labor are the most effective, safe and acceptable to women.

Two low cost interventions—misoprostol tablets and transcervical Foley catheterisation—are already used in low resource settings. In the present study, 602 women in a government hospital in India were randomly assigned to either receive oral misoprostol tablets or Foley catheter induction to induce labor.

Rates of uterine hyperstimulation were very low in both groups and no differences were seen in neonatal morbidity. The results showed that women in the misoprostol arm had a 10 percent higher rate of vaginal birth within 24 hours and less need for caesarean section. Women in the misoprostol group were also more satisfied with the outcome than those induced with the catheter method.

“In our analysis, the use of low dose oral misoprostol was found to be more effective and more acceptable to women than a transcervical Foley catheter for induction of labor in women requiring delivery because of pre-eclampsia or hypertension,” said Professor Andrew Weeks from the University of Liverpool.

In a commentary accompanying the Lancet paper, Professors Suri and Sikka of the Postgraduate Institute of Medical Education and Research in Chandigarh, India, stated that “The results of the INFORM study are encouraging for the use of low dose misoprostol (25 μg) for induction of labor in patients with mild hypertensive disease in low resource settings.”

However, the authors recommend that further studies involving women with severe, early onset hypertensive disease and intrauterine growth restriction be carried out.

The article can be found at: Mundle et al. (2017) Foley Catheterisation Versus Oral Misoprostol for Induction of Labor in Hypertensive Women in India (INFORM): A Multicentre, Open-label, Randomized Controlled Trial.


Source: University of Liverpool; Photo: Shutterstock.
Disclaimer: This article does not necessarily reflect the views of AsianScientist or its staff.

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