Objectives: To compare the efficacy of two different techniques for cervical ripening and labour induction in early third trimester pregnancy.Study design: This is a randomized controlled clinical trial. Two hundred pregnant women in early third trimester were enrolled in the study. They had either intrauterine fetal death or severe preeclampsia which necessitated pregnancy termination but patients refused cesarean delivery due to low chance of postnatal survival. Subjects were randomized into two groups: in group 1: an Intrauterine Foley catheter was inserted plus 4 doses of misoprostol 50μg every 6 hours. In group 2: Misoprostol only was administered in a dose of 50μ every 6 hours
Results: There was significant shortening of the interval from induction to establishment of active phase in nulliparous women in the first group (P=0.003) with significant reduction of induction to delivery time interval in both nulliparous and multiparous women in the same group more than that in the misoprostol group (P=0.006 and 0.001 respectively). The number of cesarean deliveries due to failed induction were significantly reduced in the first group among nulliparous women (P=0.02) in comparison to group 2. There were no cases of chorioamnionitis or postpartum endometritis in women used Intrauterine Foley catheter.
Conclusion: A combination of Intrauterine Foley catheter plus misoprostol was more effective than misoprostol alone in cervical ripening and labour induction in early third trimester pregnancy