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Updated: Dec 31, 2025

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Labor induction at full-term and post-term pregnancies.

Anna Modrzyńska, Małgorzata Radoń-Pokracka, Magdalena Płonka1

  • 1Department of Obstertics and Perinatology, Jagiellonian Univeristy Medical College, Krakow, Poland. magdalena.maria.plonka@interia.pl.

Folia Medica Cracoviensia
|January 7, 2020
PubMed
Summary

Vaginal misoprostol is more effective for labor induction than intracervical dinoprostone. Combining dinoprostone with a Foley catheter or other methods improves induction efficacy, with no significant difference in C-section rates.

Keywords:
induction of laborFoley catheterdinoprostonemisoprostolprostaglandins

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Area of Science:

  • Obstetrics and Gynecology
  • Reproductive Medicine

Background:

  • Labor induction is a common obstetric intervention to initiate childbirth before spontaneous labor.
  • Cervical ripening and uterine contractions are key goals of labor induction.

Purpose of the Study:

  • To evaluate the efficacy of labor induction methods including vaginal misoprostol, intracervical dinoprostone, and Foley catheter.
  • To compare the rates of delivery modes and emergency Cesarean sections due to birth asphyxia among different induction protocols.

Main Methods:

  • A retrospective review of 403 singleton pregnant women undergoing pharmacological labor induction at term.
  • Patients were divided into vaginal misoprostol (n=66) and intracervical dinoprostone (n=337) cohorts, with dinoprostone subgroups including PGE2 alone, PGE2+Foley catheter, and PGE2+Foley catheter+PGE1.

Main Results:

  • Vaginal misoprostol showed higher induction effectiveness (90.9%) compared to intracervical dinoprostone (51.3%).
  • Combining dinoprostone with a Foley catheter (82.8%) or PGE1 (83%) improved efficacy.
  • No significant difference in overall Cesarean section rates was observed between misoprostol and dinoprostone cohorts.

Conclusions:

  • Intracervical dinoprostone is potentially safer but less effective for labor induction than vaginal misoprostol.
  • Sequential use of other methods after dinoprostone enhances induction success.