Sequential Versus Concurrent Use of Vaginal Misoprostol Plus Foley Catheter for Induction of Labor: A Randomized Clinical Trial

Abstract

Concurrent use of vaginal misoprostol plus Foley catheter for labor induction was associated with shorter induction-to delivery interval compared to sequential use, and it increases the rate of vaginal delivery in the first 24 h.

Induction of labour with cervical ripening balloon associated with oral misoprostol: an observational study comparing sequential and concurrent administration

“…Despite these limitations, our study is the rst work demonstrating some advantages for oral misoprostol administered simultaneously with CRB, in comparison to a sequential use the two methods; these results furtherly support evidence suggesting a synergic effect on the uterine cervix for concurrent combinations of mechanical and pharmacological methods for IoL [3], con rming existing data on vaginal misoprostol [31]. A concurrent use of CRB and oral misoprostol might be preferable to a sequential combination of those methods, due to a similar outcome in terms of rate of CS, with a reduction in the interval of time from IoL to delivery and a higher rate of VD within 24 hours, and no signi cant difference for maternal or perinatal adverse events.…”

“…These results are consistent with previous Literature focusing on the potential advantages of simultaneous association of CRB and misoprostol, which highlighted mainly a difference in terms of shortening time to delivery with no increase in CS rates or adverse events [9][10][11][12][13]32]. Most works compared the association of those methods to their use as single agents; direct comparison between a sequential or concurrent scheme was carried out for vaginal misoprostol in a single study, showing similar results in terms of shorter time to delivery and higher rate of VD within 24 hours, with no difference for CS risk [31].…”

“…PPH was the most frequently reported adverse outcome (8.3% and 13.3% of patients), with an apparently higher incidence than the 2.5-5% rate reported in several population-based studies [34]; however, in settings where blood loss is measured with objective methods, the prevalence has proved to be similar, reaching 10-13% overall [35,36]. IoL is a known risk factor for PPH, probably because supra-physiological stimulation of uterine contractions leading to myometrium fatigue and post-partum atony [37]; a potentially higher risk might appear in concurrent use of IoL methods, with rates of severe PPH reaching 7-8% in some works [19,21,31], although in the present study there was only a signi cantly greater blood loss, without increase in PPH rate. Uterine tachysystole occurred in a single case with concurrent CRB and misoprostol administration; this result is in line with the results of other studies [19], and seems to con rm the low risk of hyperstimulation for both oral misoprostol and CRB use [5][6][7][8], even when used simultaneously [13].…”

Mechanical methods for induction of labour

“…In total, 138 studies were excluded (see Characteristics of excluded studies), 74 studies (102 reports) in this update. In this update, most of the excluded trials (54 studies) made comparisons not within the scope of this review (Ahmad 2015; Arsenijevic 2012; Arshad 2016; Caughey 2007; Connolly 2016; Connolly 2017; Demirel 2015; Edwards 2017; El‐Khayat 2016; El Sharkwy 2017; Forgie 2016; Forooshani 2011; Fruhman 2017; Gadel 2015; Ghanaei 2009; Ghanaie 2013; Gibson 2013; Gu 2015; Haghighi 2015; Hallak 2008; He 2000; Hill 2013; Hussein 2012; Ifnan 2006; Jonsson 2011; Kehl 2012; Kehl 2015; Lam 2006; Leong 2017; Levine 2016; Lutgendorf 2012; Manish 2016; Mattingly 2015; McGee 2016; Mei‐Dan 2012a; Mei‐Dan 2014; Movahed 2016; Mullin 2014; Neethurani 2013; Rameez 2007; Rezk 2014; Saad 2016; Salmeen 2012; Sandberg 2017; Schoen 2017; Sharma 2015a; Sharma 2017; Siddiqui 2013; Torbenson 2015;Walfisch 2015; Wickramasinghe 2014; Wilkinson 2015; Yaddehige 2015; Zakaria 2017). Four studies were not randomised trials (Du 2015; Miller 2015; Naseem 2007;…”

“…no information could be obtained (authors were contacted)Du 2015Not randomised. women could choose induction methodEdwards 2017Foley + PGE2 vs Foley => not within scope of reviewEl Sharkwy 2017Foley + miso vs Foley (and miso after 12 hours) => not within scope of reviewEl‐Khayat 2016Foley + isorbide mononitrate vs misoprostol => not within scope of reviewEl‐Torkey 1995Foley + EASI vs Foley => not in scopeEmery 1988No information.EUCTR 2012Trial registration, expected end date expired > 2 years. no information obtained (authors were contacted)Filshie 1992Insufficient information.Forgie 2016Placement stylette vs no stylette => not within scope of reviewForooshani 2011Foley vs laminaria => not within scope of reviewFruhman 2017Tension vs no tension => not within scope of reviewGadel 2015Cervical ripening in case of stillbirthGarebedian 2016Foley vs expectative managementGhanaei 2009Foley + oxytocin vs EASI + oxytocinGhanaie 2013Foley +oxytocin vs EASI + oxytocin vs PGE2 + oxytocin => not within scope of reviewGibson 2013different kind of traction applied => not within scope of reviewGilson 1996Dilapan vs no treatment => not in scopeGonsoulin 1989No clinical outcome reported.Gower 1982Laminaria vs placebo => not in scopeGreybush 2001High‐dose misoprostolGu 2015Low‐ vs high‐volume balloon => not within scope of reviewGuinn 2004Compares 2 mechanical regimens.Haghighi 2015EASI vs isoniazide => not within scope of reviewHallak 2008…”