In this prospective, randomized trial of 123 pregnant women undergoing induction of labor with an unfavorable cervix (Bishop score [less than or equal to] 6), the mean induction-to-delivery time was 3.1 hours shorter for the combination of the Foley bulb and vaginal misoprostol than for vaginal misoprostol alone (95% CI, -5.9 to -0.3).
The primary outcome of induction-to-delivery time is not clinically important, particularly when multiparous women and those with a Bishop score above 5 are included, as they were in this study.
The mean induction-to-delivery
interval found in this study was 7.5 min.
Pre-induction sonographic measurement of cervical length in prolonged pregnancy: the effect of parity in the prediction of induction-to-delivery
* OUTCOMES MEASURED Induction-to-delivery interval, total duration of labor, maximum dose of oxytocin used during induction, and mode of delivery were the primary maternal outcomes reported.
Nulliparous women assigned to the membrane sweeping group who required cervical ripening with prostaglandins had shorter induction-to-delivery intervals (13.6 vs 17.3 hours, P=.043), required less oxytocin, were more likely to have a spontaneous vaginal delivery (83.3% vs 58.2%, P=.01; number needed to treat [NNT]=4) and were less likely to require a cesarean delivery (6.3% vs 21.8%, P=.01; NNT=7).
"Smaller institutions with limited medical staff should be aware of the potential prolongation of the induction-to-delivery
interval" in cases in which the fetus is alive at the start of induction, said Dr.