Pharmacologic vs. Physical Approaches to Cervical Ripening in Hypertensive Women

Labor induction can be lengthy and expensive, a particular concern for hypertensive women in developing countries; hence, optimizing the efficiency of cervical ripening is likely to yield substantial individual and public health benefits. Investigators in India conducted a multicentered trial to address whether oral misoprostol or transcervical Foley catheter placement is associated with shorter delivery times in women at excess risk for obstetric complications. Six hundred participants with hypertensive disorders of pregnancy necessitating labor induction were randomized to receive a transcervical Foley balloon filled with 30 mL saline (≤12 hours or until expulsion or labor onset) or oral misoprostol (25–50 µg every 2 hours until labor ons…