A randomized comparison of oral misoprostol versus Foley catheter and oxytocin for induction of labor at termx kx Presented at the Nineteenth Annual Meeting ofthe Society for Matemal-Fetal Medicine, San Francisco, California, January 18-23, 1999 Dorel Abramovici, MD, Stove Goldwasser, MD, Bill C. Mabio, MD, Brian M. Mercer, MD, Reboesa Goldwassex. RN, Baha M. Sibai, MD Division of Maiernal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Tennessee. Memphis, Abstract Objective: We sought to compare the efficacy and safety of oral misoprostol administered to patients with the efcacy and saety na contro group treated with a Foley catheter ard oxytocin for induction of labor. Study Design: Two hundred patents requing induction of labor at term wih a Bishop score of 5 were randomized to receive oral misoprostel ora cervical Foley catheter pls oxytocin Patients inthe mseprostl group recewed SD pg at hour intervals fora maximum of 6 doses or ntl an adequate contraction pater developed. Those inthe contol group had a Foley catheter nsered nthe cervix, whereas oxytocin was administered intravenously by @ standard incremental fusion proto olto a maximum dose of 26 mUlmin, Results: In mutiparus patents the percentage delivered of tet neonates within 24 hours and the median induction to-debvery times were similar nthe 2 groups. In nulliparous patients, however, delivery within 24 hours was significantly less likely in the misoprostol group (63.4% vs 825; P-<001), an the median induction to-delvery time was onger (23:3 hours vs 17.2 hours: P< 01), There were no afferences inthe incidence of meconium, choioarnionts, low Apgar scores, or cesarean delivery. The incidence of hyperstimulation was higher in the oxytocin-Foley group (4.1% vs 13.1%, P= .02). Conelusion: Oral misoprostol is as effective as oxytocin-Foley catheter for inducing labor in multiparous women. ‘Misoprostol appears less efficacious in nulliparous patients. (Am J Obstet Gynecol 1999,181: 1108-12.)