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Faster Delivery for Induction With Misoprostol Plus Cervical Foley

Combination methods result in faster time to delivery compared with misoprostol, Foley alone

THURSDAY, Nov. 10, 2016 (HealthDay News) — For women undergoing induction, receipt of misoprostol-cervical Foley is associated with an increased likelihood of delivery before those receiving either method alone, according to a study published in the December issue of Obstetrics & Gynecology.

Lisa D. Levine, M.D., from the University of Pennsylvania Perelman School of Medicine in Philadelphia, and colleagues conducted a randomized trial comparing four induction methods: misoprostol alone, Foley alone, misoprostol-cervical Foley concurrently, and Foley-oxytocin concurrently. To compare the groups pairwise, a sample size of 123 per group was planned (492 patients overall); 491 were randomized and analyzed.

The researchers found that combination methods achieved a faster median time to delivery than single-agent methods (misoprostol-Foley, 13.1 hours; Foley-oxytocin, 14.5 hours; misoprostol, 17.6 hours; and Foley, 17.7 hours; P < 0.001). Women who received misoprostol-Foley were almost twice as likely to deliver before those who received misoprostol alone and Foley alone after censoring for cesarean delivery and adjusting for parity (hazard ratios, 1.92 and 1.87, respectively); there was no significant difference for Foley-oxytocin versus single-agent methods.

“After censoring for cesarean delivery and adjusting for parity, misoprostol-cervical Foley resulted in twice the chance of delivering before either single-agent method,” the authors write.

One author disclosed financial ties to the pharmaceutical industry.

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