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One quarter of pregnant women undergo induction of labor for medical indications (e.g., hypertension, diabetes, fetal growth restriction) or social reasons. An unfavorable cervix (Bishop score <6) can be ripened with oral misoprostol or cervical balloon catheter. Researchers in the Netherlands compared the efficacy and complication rates of these two interventions in a trial involving 1859 women with an unfavorable cervix at ≥37 weeks' gestation. Participants were randomized to oral misoprostol (50 µg every 4 hours; limited to 3 doses daily) or placement of a 30-mL Foley catheter (16 or 18 French).
Fetal outcomes (Apgar score, umbilical cord pH, or rate of a worrisome fetal heart rate tracing during labor) did not differ significantly betwee…