Comparing the effects of vaginal misoprostol, laminaria, and extra amniotic saline infusion on cervical ripening and induction of labor
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ObjectiveThis study aimed to compare the effects of vaginal misoprostol, laminaria, and extra-amniotic saline infusion (EASI) oncervical ripening. MethodsThis randomized controlled trial was conducted on 195 women with singleton pregnancies and unripe cervices. Participants were randomly allocated to 3, 65-person groups: a misoprostol, a laminaria, and an EASI group. Theinterventions in the misoprostol, laminaria, and EASI groups included a single 25-μg vaginal misoprostol suppository,an intracervical laminaria, and a transcervical Foley catheter, respectively. The groups were compared with eachother regarding time intervals from labor induction to labor active phase and delivery, cervical dilation, Bishop scores6 hours after induction, delivery type, length of hospital stay, and complications. ResultsThere were no significant differences among the groups regarding maternal ages, gestational ages, body mass indices,baseline cervical dilations, and Bishop scores (P>0.05). Six hours after induction, the Bishop score and cervical dilationwere significantly greater in the EASI group than in the other 2 groups (P<0.001). Moreover, time intervals from laborinduction to labor active phase and delivery in the EASI group were significantly short (P<0.001). The rates of cesareansection, fetal distress, placental abruption, and meconium staining in the misoprostol group were significantly high(P<0.05), and the length of hospital stay in the EASI group was significantly short (P<0.001). ConclusionEASI is a safer and more effective method for cervical ripening. Considering its inexpensiveness, easy accessibility, andgreater effectiveness, EASI is recommended for cervical ripening. Trial RegistrationIranian Center for Clinical Trials Identifier: IRCT20170513033941N39
Abstract
ObjectiveThis study aimed to compare the effects of vaginal misoprostol, laminaria, and extra-amniotic saline infusion (EASI) oncervical ripening. MethodsThis randomized controlled trial was conducted on 195 women with singleton pregnancies and unripe cervices. Participants were randomly allocated to 3, 65-person groups: a misoprostol, a laminaria, and an EASI group. Theinterventions in the misoprostol, laminaria, and EASI groups included a single 25-μg vaginal misoprostol suppository,an intracervical laminaria, and a transcervical Foley catheter, respectively. The groups were compared with eachother regarding time intervals from labor induction to labor active phase and delivery, cervical dilation, Bishop scores6 hours after induction, delivery type, length of hospital stay, and complications. ResultsThere were no significant differences among the groups regarding maternal ages, gestational ages, body mass indices,baseline cervical dilations, and Bishop scores (P>0.05). Six hours after induction, the Bishop score and cervical dilationwere significantly greater in the EASI group than in the other 2 groups (P<0.001). Moreover, time intervals from laborinduction to labor active phase and delivery in the EASI group were significantly short (P<0.001). The rates of cesareansection, fetal distress, placental abruption, and meconium staining in the misoprostol group were significantly high(P<0.05), and the length of hospital stay in the EASI group was significantly short (P<0.001). ConclusionEASI is a safer and more effective method for cervical ripening. Considering its inexpensiveness, easy accessibility, andgreater effectiveness, EASI is recommended for cervical ripening. Trial RegistrationIranian Center for Clinical Trials Identifier: IRCT20170513033941N39
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