Clinical effectiveness of different methods on cervical maturation and induction of labor in full-term pregnant women

Objective To compare the effectiveness and safety of Propess (dinoprostone suppositories), misoprostol, Foley urinary catheter and oxytocin in promoting cervical maturation in full-term pregnant women. Methods A total of 268 women with full-term pregnancy and indications for induction of labor who delivered in the Affiliated Hospital of Xuzhou Medical University from May 2018 to May 2019 were selected and their clinical data were retrospectively analyzed. According to their corresponding methods of labor induction, they were divided into four groups: a Propess group, a Foley catheter group, a misoprostol group and a low-dose oxytocin group. Their cervical maturation degree, delivery time and cesarean section were compared and neonate condition and post-delivery complications were recorded. Results Compared with the oxytocin group, remarkable improvement in cervical maturation was found in the Propess group, the Foley catheter group and the misoprostol group (P<0.05). For those with a Bishop score of 0 to 3, misoprostol treatment resulted in better cervical maturation than Foley catheter (P<0.05). In contrast, no statistical difference was found in cervical maturation for those with a Bishop score of 4 to 5 (P>0.05). The Propess group presented remarkable decreases in the duration of the first stage of labor, the total stage of labor, and cesarean section rate compared with the oxytocin group (P>0.05). There was no statistical difference in neonate body weight, 5 min Apgar score, and the cases of neonate asphyxia, meconium-stained amniotic fluid and referring to neonatal intensive care unit (NICU) among these group (P>0.05). There were 3 cases of metrypercinesia in the Propess group, 1 case in the Foley catheter group, and no case in the misoprostol group and the low-dose oxytocin group. Conclusions Propess, Foley catheter, and misoprostol are more effective than oxytocin for induction of labor in full-term pregnant women. Propess is expensive, while Foley catheter and misoprostol are safe, cheap and easy to operate, which can be individually selected.