Comparison of effectiveness of Foley catheter versus vaginal misoprostol for cervical ripening in induction of labour in Gedeo zone public hospitals, Ethiopia, 2022. Quasi-experimental design

Abstract

Background Induction of labor is defined as iatrogenic stimulation of uterine contractions to cause the delivery of fetus before the onset of spontaneous labour. An unfavorable cervix is a critical factor the obstetrician must overcome to improve the efficacy of induction of labor. At present, both medical and mechanical methods have been applied for cervical ripening in women with an unfavorable cervix. In developing countries like Ethiopia, conventionally cheap and feasible method used for preinduction cervical ripening is transcervical Foley’s catheter and misoprostol become practically important. So this study is designed to investigate the effectiveness of the most commonly ripening techniques (Foley catheter and vaginal misoprostol) in Gedeo zone. Method This is a quasi-experimental study to compare the effectiveness of Foley catheter and vaginal misoprostol for cervical ripening for labor induction. It was conducted in 120 pregnant mothers coming for induction who fulfil the inclusion criteria. Sixty mothers were assigned to the Foley catheter (group 1) and the remaining 60 mothers were grouped to misoprostol (group 2). Data was collected consecutively with a structured tool for both groups by trained data collector. Data analysis was done using the SPSS version 25. Chi-square analysis was used for comparing proportions of categorical variables while the student’s independent ’t’ test was used for comparing means of continuous variables where applicable. To calculate the time intervals, log rank test life table was used. P- Value was calculated to declare level of statistical significance at P < 0.05. Result the 41(68.3%) participants of folley catheter group and the 49(81.7%) of misoprostol group had favourable cervix within the 24 hrs. The mean time interval from the starting of ripening to favourable cervix was found shorter in the misoprostol group (10.27 ± 2.506) than the Foley catheter group (11.78 ± 2.151). In the induction of labor incidence of meconium was more in the misoprostol group than the Foley catheter group. The successful outcome of the induction was 33(80.5%) in Foley catheter group and (35(71.4%) misoprostol group. The mean time interval between starting of induction to delivery was almost the same between the two groups (7.56 + 2.97) and (6.96 + 2.226) respectively.