Sublingual Misoprostol versus Foley catheter for cervical ripening in women with preeclampsia or gestational hypertension: A randomized control trial|
Ayati, Sedigheh; Hasanzadeh, Elahe; Pourali, Leila; Shakeri, Mohammadtaghi & Vatanchi, Atiye
Background: Delivery is the only definite cure for hypertensive disorders. Therefore,
cervical ripening and labor induction are important to achieve favorable outcomes.
Objective: This Randomized Control Trial (RCT) is aimed to compare the effects of
sublingual misoprostol and Foley catheter in cervical ripening and labor induction
among patients with preeclampsia or gestational hypertension.
Materials and Methods: A total number of 144 women with preeclampsia or gestational
hypertention with indication of pregnancy termination, who were referred to academic
hospitals of the University of Medical Sciences in Mashhad, Iran, between March 2015
and December 2016, were randomly divided into two groups. In group one (n = 72), 25
μg of misoprostol tablet was administrated sublingually every 4 hr up to six doses. In
group two (n = 72), a 16F Foley catheter was placed through the internal cervical os,
inflated with 60 cc of sterile saline.
Results: There were no significant differences between groups regarding the demographic
characteristics, primary bishop score, and pregnancy termination indication.
The cervical ripening time (primary outcome) (8.2 vs 14.2 hr, p < 0.00), induction to
delivery interval (15.5 vs 19.9 hr, p < 0.00), and vaginal delivery before 24 hr (63.9%
vs 40%, p = 0.03) were significantly different between the two groups. There was
no significant difference between groups in view of oxytocin requirement (p = 0.12),
neonatal Apgar score (p = 0.84), or neonatal intensive care unit admission (p = 78).
Conclusion: This trial showed that the application of sublingual misoprostol, compared
to the Foley catheter, can reduce cervical ripening period and other parameters related
to the duration of vaginal delivery. This misoprostol regimen showed inconsiderable
Preeclampsia; Labor induction; Misoprostol; Pregnancy.