Comparison of changes in pre-induction cervical factors' scores following ripening with transcervical Foley catheter and intravaginal misoprostol

Abstract

The study compares the changes in the cervical factors in pre-induction cervical ripening with both transcervical Foley catheter and Intravaginal Misoprostol. This was a randomised prospective study of pregnant women, with singleton gestations who presented for antenatal care and delivery at a tertiary health institution in the South-western Nigeria between 1st March 2003 and 31st March 2004. One hundred and two (102) patients received 50µg intravaginal Misoprostol and Ninety-six (96) received size 16F Transcervical Foley catheters. Both groups were similar at the baseline. Misoprostol group showed greater improvement in the final cervical length score, with 38.4% and 58.6% scoring 2 and 3 respectively, in contrast with the Foley catheter group where 77.7% had final score of 1, with only 16% scoring 2 and none scored 3 (P = 0.00). Ninety-one percent of the patients in the misoprostol group achieved the maximum cervical consistency score of 2, contrasting with the 31.9% in the Foley Catheter group (P = 0.00). 64.9% of the patients in the Foley catheter group did not achieve appreciable change in cervical consistency. Our findings indicate that intravaginal misoprostol was more effective in improving the scores of cervical length and consistency, while transcervical Foley catheter was better at improving the cervical os dilatation score at pre-induction cervical ripening. The clinical implication is that, patients for pre-induction cervical ripening can be selected for either of these ripening agents based on which cervical factors require improvement in scores.