Indication For Induction Of Labor Research Articles

A comparison of oral versus vaginal misoprostol for induction of labor at term, at the Ahmadu Bello University Teaching Hospital, Zaria

Background: The comparison of same,equal and low dose of misoprostol by the oral and vaginal routes for induction of labour at term requires further elucidation. Objective: To compare the efficacy and safety of 25 micrograms (ug) of oral misoprostol with 25ug vaginal misoprostol for induction of labor at term.Methods: A randomised control trial that involved 169 consented women with indication for induction of labor. A total of 85 women had oral misoprostol while 84 women had vaginal misoprostol. The oral misoprostol dose (25ug) was repeated every 2 hours, while the vaginal dose (25ug) was repeated every 6 hours for a maximum duration of 24 hours or when need arose for intervention. Data was analysed using SPSS version 20. Results: The mean induction-delivery interval was significantly shorter (18.48 +/- 2.01 vs. 22.82 +/- 2.50, P = 0.00), with more vaginal deliveries (88.2% vs. 85.7%, P = 0.00) in the oral group compared to the vaginal group respectively. The cardiotocographic abnormalities in the vaginal group were significantly higher than the oral group (8.3% vs. 1.2%, P = 0.03). There were more foetal distress and meconium stained liquor in the vaginal group but not statistically significant.

Outcomes of induction of labour in nulliparous women at 38 to 39weeks pregnancy by clinical indication: An observational study.

Knowledge of the outcomes of induction of labour for different indications is sparse. To describe the mode of birth and other outcomes for nulliparous women induced at 38-39weeks gestational age by indication for induction of labour. This was a retrospective observational study in a tertiary referral hospital, and a metropolitan teaching hospital in Sydney. The study population was nulliparous women with induction of labour at 38 or 39 completed weeks of pregnancy and a singleton, cephalic presenting baby planning a vaginal birth, from 2009 to 2016. The indication for induction of labour was classified into 12 groups. Mode of birth and other maternal and perinatal outcomes were described in each group, for women who spontaneously laboured at 38 or 39weeks, and for women who gave birth from 40 completed weeks onward. The main outcome measure was mode of birth. There were 3330 women with induction of labour at 38 or 39weeks gestation. Rates of vaginal birth varied widely, ranging from 54% when the indication for induction was suspected large fetus, to 82% when the indication was suspected fetal compromise, and was 74% overall. Indications for caesarean delivery also varied by indication for induction. Among women giving birth ≥40weeks gestational age, 75% had a vaginal birth. In nulliparous women, rates of vaginal birth following induction of labour at 38 or 39weeks gestation vary widely according to the indication for induction. These data are useful for antenatal counselling.

Care of Women with Obesity in Pregnancy

Care of Women with Obesity in Pregnancy

Double-balloon catheter versus dinoprostone insert for labour induction: a meta-analysis.

To assess the efficacy and safety of a double-balloon catheter versus dinoprostone insert for labour induction. PubMed, MEDLINE, Embase, ClinicalTrials.gov, and the Cochrane Central Register of Clinical Trials databases were searched from 1985 to April 2018. Randomized controlled trials that compared a double-balloon catheter and dinoprostone insert for cervical ripening were identified. Eligible study populations consisted of women with singleton pregnancies that had any indication for labour induction and were randomly assigned to undergo induction with a double-balloon catheter or dinoprostone insert. The main outcomes were incidence of vaginal delivery within 24h and caesarean section, and neonatal outcomes. Five randomized trials (603 women; 305 with a double-balloon catheter and 298 with a dinoprostone insert) were eligible for inclusion. No differences were observed between the two groups in terms of vaginal delivery within 24h [relative risk (RR) 1.21, 95% confidence interval (CI) 0.93-1.59] and incidence of caesarean section (RR 0.99, 95% CI 0.77-1.27). Compared with the double-balloon catheter, the dinoprostone insert was associated with a reduced need for oxytocin administration in the process of labour induction (RR 1.95, 95% CI 1.45-2.62). However, there was a higher incidence of excessive uterine activity (RR 0.17, 95% CI 0.06-0.54) and neonatal umbilical cord arterial blood pH < 7.1 (RR 0.36, 95% CI 0.15-0.84) in the dinoprostone insert group. This review showed that the efficacy of labour induction using both the double-balloon catheter and dinoprostone insert was similar. However, the double-balloon catheter seemed to be a safer method.

Oral versus Vaginal Misoprostol for Labour Induction : A Comparative Study

Objective: To compare the efficacy and safety of hourly titrated oralmisoprostol in solution (OMS) with vaginal misoprostol (PV) forlabor induction.Methods: Randomized Controlled Trial (RCT), double blind-add onthe study was conducted from January-November 2016 in deliveryward of Moh. Hoesin general hospital. Women 30 weeks of gestationwith an unfavorable cervix (Bishop score 6) and an indicationfor labor induction were randomly assigned to receive titrated oralor vaginal misoprostol. The OMS group received a basal unit of20 ml misoprostol solution (1 g/ml) every 1 hour for four dosesand then were titrated against individual uterine response. In theabsence of regular uterine contractions, the dose was increased to40 ml hourly for four doses and then 60 ml for four doses. Thevaginal group received 25 g every 4 hours until attaining a morefavorable cervix for three doses. All the subjects received amylumplacebo. In labor within 12 hours was the primary outcome.Results: A total of 30 women were enrolled in this study. One subjectin the OMS group was dropped out due to eclamptic seizure. Theaverage interval from induction until in labour in OMS group was5.753.14 hour and 6.604.46 hour in PV group (p = 0.56). In labourstage was achieved within 12 hours in 14 women (100%) in OMSgroup and 14 women (93.3%) in PV group (p = 1.00). Vaginaldelivery was achieved within 24 hours in 13 women (92.9%) inOMS group and 15 women (100%) in PV group. The incidence ofuterine hyperstimulation/ tachysystolic was 7.1% in OMS groupcompared with 13.3% in PV group. Fetal distress was found only 1case (7.1%) in OMS group. There was no difference in the maternaland neonatal outcome of labor in both the groups.Conclusion: Oral titrated in solution, and vaginal route ofadministration of misoprostol for induction of labour areequally effective and safe.[Indones J Obstet Gynecol 2018; 6-2: 89-97]Keywords: hourly titrated oral misoprostol in solution, oral misoprostol,randomized controlled trial, vaginal misoprostol

Clinical governance in the management of induction of labour.

To determine whether dissemination of explicit guidelines, developed in consensus with stakeholders, for the processes of induction of labour (IOL), results in reduction of variability in clinical practice. A prospective behaviour modification interventional study. The study was conducted in the department of Obstetrics and Gynaecology at the Aga Khan University, Karachi, between January 1 and August 31, 2002. In a total of 142 conveniently sampled women, undergoing IOL, pre-identified quality assessment indicators were measured. After collection of data from initial 71-women (pre-intervention group) mutually agreed guidelines for clinical practice were disseminated, over a period of time, among consultants, residents and nurses. These indicators were again measured in subsequent 71 women (post-intervention group) to evaluate magnitude of residual non-conformities in these processes. Following behaviour modification interventions, nonconformities in consultants and residents-dependent processes like timely review of patients by consultants (72 vs 1.4%, p value <0.0001), documentation of indication for IOL (66.2 vs 16.9%, p value <0.0001), method of induction for IOL (56.3 vs 28.2%, p value 0.0001), and calculation of Bishop score before IOL (38.0 vs 4.2 %, p value <0.0001) were significantly reduced. Dissemination of explicit guidelines developed in consensus with stakeholders significantly reduces variability in clinical practice. Our model can be used for improving quality of care in other areas of obstetric health care.

Does Indication for Induction of Labor Impact the Duration of Induction? [10J

INTRODUCTION: Nearly 25% of pregnancies in the US result in an induction of labor (IOL). The impact of IOL indication on IOL duration is unknown. We aim to assess that impact. METHODS: This retrospective cohort study included all nulliparous women with non-anomalous, singleton, vertex pregnancies who underwent IOL at a tertiary-care academic hospital in 2015. IOL duration was calculated as time from administration of first induction agent to delivery. There were several IOL indications, listed below. The primary outcome was IOL duration. Secondary outcomes included operative delivery (OD) and cesarean delivery (CD) rates. The data were analyzed using the Kruskal-Wallis test. RESULTS: Four hundred and twenty women were included. The most common IOL indications were prolonged gestation (PG) (n=129, 30.7%), hypertensive disorder (HTN) (n=106, 25.2%), diabetes (DM) (n=42, 10%), and non-reassuring fetal status (NRFS) (n=19, 4.5%). The median times to any delivery (cesarean or vaginal) by indication were (in hours): PG 28.8, HTN 30.8, DM 33.3, NRFS 20.8, other 23.6. The median times to spontaneous VD were: PG 26.2, HTN 27.8, DM 24.2, NRFS 31.8, other 21.4. Differences within both groups were statistically significant (p &lt; 0.005). OD rates were: PG 13.7%, HTN 13.6%, DM 9.5%, NRFS 15.8%, other 13.3%. CD rates were: PG 28.2%, HTN 27.1%, DM 38.1%, NRFS 26%, other 29.8%. Differences within these groups were not statistically significant (p &gt; 0.05). CONCLUSION: IOL duration is dependent on IOL indication. Operative and cesarean delivery rates are not. These data may inform provider and patient expectations surrounding IOL duration and outcome.

Indication for Early Term Induction of Labour in Nulliparous Women and Mode of Birth

Indication for Early Term Induction of Labour in Nulliparous Women and Mode of Birth

Relationship between Bishop Score and Success of Induction of Labour in Federal Teaching Hospital, Abakaliki, Ebonyi State

Background: The ripeness of the cervix is of critical importance to the probability of successful labour induction. Aim: To determine the relationship between successful induction of labour and Bishop score. Materials and Methods: A retrospective study of all obstetric patients who had induction of labour between January 1st 2012 and December 31st 2015 was done in Federal Teaching Hospital Abakaliki. The information obtained from patients’ case notes was analyzed using descriptive and inferential statistics at an alpha level of 0.05 for all statistical tests. Results: During the study period, there were 9548 deliveries; 2.76% (264) was by induction of labour with success rate of 75.4%. The mean age of the women was 28.4 ± 5.8 years; majority where nulliparous (45.45%). The most common indication for induction of labour was postdatism (43.94%). Success of induction of labour was most likely at Bishop score of 8 to 10 (OR = 0.79, 95% CI 0.72 - 0.84). Induction delivery interval was shortest with use of Foley catheter and misoprostol. Conclusion: Our study has shown that success of induction of labour was most likely at Bishop Score of 8 - 10. We advocate the use of Foley catheter and misoprostol for cervical ripening especially when there is need to expedite delivery.

Comparison of 25 Microgram of Sublingual Misoprostol with 25 Microgram Vaginal Misoprostol for Induction of Labour at Term

Comparison of 25 Microgram of Sublingual Misoprostol with 25 Microgram Vaginal Misoprostol for Induction of Labour at Term

Comparison of single- and double-balloon catheters for labor induction: a systematic review and meta-analysis of randomized controlled trials.

There is a paucity of head-to-head randomized trials that compare single- and double-balloon catheters, and the results of the available data in terms of time from catheter insertion to delivery and delivery mode are mixed. This meta-analysis of randomized controlled trials compares the efficacy of single- and double-balloon catheters in women undergoing labor induction. Searches were made in MEDLINE, EMBASE, PubMed, ClinicalTrials.gov, and the Cochrane Library from inception through June 2016. Peer-reviewed randomized and quasi-randomized trials that compared single- and double-balloon catheters head-to-head for cervical ripening or labor induction were identified. Eligible study populations consisted of women with singleton pregnancies that had any indication for labor induction and were randomly assigned to undergo induction with a single- or a double-balloon catheter. The primary outcome was time from catheter insertion to delivery and delivery mode. The secondary outcomes were intrapartum fever or chorioamnionitis, woman's satisfaction, and neonatal Apgar score. Of the 520 records identified, five randomized trials (996 women; 491 with single-balloon and 505 with double-balloon catheters) were considered eligible and included in the meta-analysis. Time from catheter insertion to delivery did not differ between the two types of catheter (p = 0.527; WMD -0.87; 95% CI: -3.55, 1.82). The incidence of cesarean delivery also did not differ (p = 0.844; RR 0.97; 95% CI: 0.69, 1.35). Delivery within 24 h, delivery mode, incidences of intrapartum fever or chorioamnionitis, and neonatal Apgar score <7 at 5 min did not differ between the two types of catheter as well. Women who were induced with the single-balloon catheter were more satisfied (p = 0.029; WMD 0.56; 95% CI: 0.06, 1.06). Time from catheter insertion to delivery and delivery mode were comparable between the two types of catheter.

Особенности методов родоразрешения у рожениц с маловодием

The objective: to study the rate of different obstetric pathologies followed by oligohydramnios, and to determinate the specifities of delivery methods in pregnant with oligohydramnios. Materials and methods. There was done the retrospective analysis of 100 birth histories of pregnant with oligohydramnios. Эt was confirmed, that the cause for oligohydramnios in 54% of cases was premature rupture of membranes (PROM), in 10% of cases intrauterine growth restriction (IUGR), dead fetus – in 19%, congenital abnormalities of the fetus in 8% and moderate and severe preeclampsia in 9% cases. The rate of the spontaneous labor was 57%; 12% of labors was induced and 37% ended by cesarean section. Results. The study showed that spontaneous labor (n=51) resulted in 47% of cases with very early labor, 41.1% of cases with early premature labor, and 11.8% with premature labor. In case of induced labor (n=12), the main indication for labor induction were dead fetus (n=9), and congenital abnormalities of the fetus (n=3). In 83.3% of cases induction of the labor was perfomed in 22-28, in 16% of cases in 29-31 weeks of gestation. Conclusion. The rate of cesarean delivery in pregnant with oligohydramnios was 37%. The main indications for cesarean birth were: dead fetus, uterine car – 100%, severe preeclampsia – 18.2%, PROM – 13.2%, and breach presentation and acute hypoxia in 12.1% of cases. So, pregnant with oligohydramnios are in risk group for premature birth. Key words: oligohydramnios, dead fetus, premature rupture of membranes, congenital abnormalities of the fetus, premature birth.

Labour induction practices in France: A population-based declarative survey in 94 maternity units

IntroductionIn 2016, 22.0% of deliveries in France were induced. The current lack of high level of evidence data about the methods and indications for induction of labour has promoted heterogeneous and non-recommended practices. The extent of these different practices is not adequately known in France today, although they may influence perinatal outcomes. The objective of this study was to report current practices of induction of labour in France. Material and methodsThis study surveyed 94 maternity units in seven perinatal networks. A questionnaire was sent by email to either the department head or delivery room supervisor of these units to ask about their methods for induction and their attitudes in specific obstetric situations. ResultsThe rate of induction varied between maternity units from 7.7% to 33% of deliveries. Most units used two (39.4%) or three or more (35.1%) agents for cervical ripening. In all, 87 (92.6%) units reported using dinoprostone as a vaginal slow-released insert, 59 units dinosprostone as a vaginal gel (62.8%) and 46 units a balloon catheter (48.9%). Only three units reported using vaginal misoprostol. Inductions without medical indication were reported by 71 (75.5%) maternity units, and 22 (23.4%) units even when the cervix was unfavourable. Obstetric attitudes in cases of breech presentation, previous caesareans, fetal growth restriction or macrosomia and prelabour rupture of the membranes varied widely. DiscussionThe variability of practices for induction of labour and the persistence of disapproved practices call for an assessment of the effectiveness and the safety of the different strategies.

Safety and effectiveness of labour induction after caesarean section using balloon catheter or oxytocin.

Induction of labour after previous caesarean section (CS) is a challenge for obstetricians due to the increased risk of uterine rupture. Common methods for labour induction are balloon catheters and oxytocin as they are considered safe. However, the effectiveness remains unclear as currently available data are limited. Therefore, we aimed to determine safety and effectiveness of balloon catheter or oxytocin for labour induction after CS. We included 179 consecutive women with a previous CS and labour induction in this retrospective study. We performed labour induction using a balloon catheter in case of a Bishop score of <6 and intact membranes, or oxytocin in the case of a Bishop score of >6 and/or premature rupture of membranes. The primary outcome was the rate of successful vaginal deliveries. We adjusted for multiple factors that may have impacted on the rate of vaginal delivery as well. The secondary outcomes were the rate of maternal and neonatal morbidities. We detected a vaginal delivery success rate of 45.8% in the catheter and of 63.9% in the oxytocin group. We identified previous vaginal birth as an independent predictive factor for successful vaginal delivery in both groups. Induction using oxytocin was a negative predictive factor for neonatal admissions. Multivariate analysis showed that post-term pregnancy decreased the likelihood of vaginal delivery. We did not detect any factors predicting uterine rupture or uterine dehiscence, which occurred with similar frequency in both groups. Finally, the neonatal admission rate was less likely with higher gestational age and oxytocin as an induction method, whereas previous vaginal birth increased the risk. Our study indicates that induction of labour with balloon catheter or oxytocin seems to be safe in women with previous CS. Labour induction using a balloon catheter in women with previous CS and unfavourable cervix has a disappointingly low success rate. We identified factors influencing vaginal delivery success rates. Women with previous CS and indications for labour induction should be informed about vaginal birth success rates and the alternative of elective repeat CS needs to be discussed.

Induction of Labor using Misoprostol in a Tertiary Hospital in the Southeast of Brazil.

Purpose To assess cases of labor induction with vaginal 25-µg tablets of misoprostol and maternal outcomes in a tertiary hospital in southeastern Brazil. Methods This was a retrospective cohort study of 412 pregnant women with indication for labor induction. Labor induction was performed with vaginal 25-µg tablets of misoprostol in pregnant women with Bishop scores < 6. Stepwise regression analysis was used to identify the factors present at the beginning of induction that could be used as predictors of successful labor induction. Results A total of 69% of the pregnant women who underwent labor induction progressed to vaginal delivery, and 31% of the women progressed to cesarean section. One or two misoprostol tablets were used in 244 patients (59.2%). Of the 412 patients, 197 (47.8%) required oxytocin later on in the labor process, after induction with misoprostol. The stepwise regression analysis showed that only Bishop scores of 4 and 5 and previous vaginal delivery were independent factors with statistical significance in the prediction of successful vaginal labor induction (β = 0.23, p < 0.001, for a Bishop score of 4 and 5, and β = 0.22, p < 0.001, for previous vaginal delivery). Conclusion Higher Bishop scores and previous vaginal delivery were the best predictors of successful labor induction with vaginal 25-µg tablets of misoprostol.

What can we do to reduce the associated costs in induction of labour of intrauterine growth restriction foetuses at term? A cost-analysis study.

To evaluate the costs associated with induction of labour in intrauterine growth restriction fetuses comparing different procedures. 150 pregnancies at term diagnosed with intrauterine growth restriction and indication for induction of labour were included. 24 were ripened with misoprostol 25μg tablets, 24 with dinoprostone 10mg vaginal insert, and 77 with Cook® cervical ripening balloon. To determine the costs of induction of labour, method of induction, intrapartum medication, epidural analgesia, type of delivery, and maternal and neonatal admissions were considered. Statistical analysis was performed using the G-Stat 2.0 free statistical software. ANOVA test was used for comparisons between quantitative parametric variables. Chi-squared test or Fisher test was used for qualitative variables. A value of p<0.05 was considered statistically significant. Up to 70.83% women in dinoprostone group gave birth within the first 24h compared to 42.66% in misoprostol group and 36.36% in CG (p<0.01). Misoprostol tablets were cheaper (9.45±1.52 US dollars) than dinoprostone or Cook® balloon (41.67±0 and 59.85±0 54.45±0 US dollars, respectively) (p<0.01). Costs related to maternal admissions were higher in CG (475.13±146.95$) than dinoprostone group (475.13±146.95$) or MG (427.97±112.65$) (p=0.03). Total costs in misoprostol group (2765.18±495.38$) were lower than in the dinoprostone group (3075.774±896.14$) or Cook® balloon group (3228.02±902.06$) groups. Misoprostol for induction of labour had lower related costs than dinoprostone or Cook® balloon, with similar obstetrical and perinatal outcomes.

The Role of Low Dose Misoprostol in Cervical Ripening and Induction of Labour Beyond the Age of Viability and its Effects on Maternal and Fetal Outcomes

This study was conducted to compare the efficacy and safety of oral (50 μg) and vaginal (25 μg) misoprostol for cervical ripening and induction of labour. Two hundred patients with indications for labour induction randomly received either 50 μg oral misoprostol every 4 h (Group-I) or 25 μg vaginal misoprostol every 4 h (Group-II), for maximum of six doses. Mean induction to delivery time, delivery within 24 hrs, mode of delivery, oxytocin use, number of doses used, failed induction rate and maternal complication and fetal outcomes were compared for the two groups. Mean induction delivery time was significantly longer in Group-I (20.55±5.59 hrs) than in Group-II (16.70±7.12 hrs) (with mean difference of 3.85 and P-value of &lt;0.001). Mean number of doses of misoprostol used for oral and vaginal misoprostol study populations were 2.61±0.94 and2.37±1.20respectively. Oxytocin augmentation was required in significantly more number of patients in oral group (80%) than in vaginal group (68%) with P-value of 0.027. There were 3 failed inductions in the oral and 4 in the vaginal group after a total of six doses of misoprostol. Incidence of maternal and fetal complications was similar between two groups. Our findings indicated that, 25μg vaginal misoprostol has the potential to induce labor as safely as, and more effectively than, 50 μg oral analogue. JMS 2017; 20(1):18-21

Transcervical Foley Bulb (TFB) and Risk of Subsequent Preterm Delivery [32O

INTRODUCTION: To evaluate if the use of a transcervical Foley balloon (TFB) for induction of labor (IOL) increases the risk of preterm delivery in subsequent pregnancies. METHODS: This was a retrospective cohort study evaluating methods of induction and subsequent pregnancy outcomes. RESULTS: 151 women were identified to have a term IOL followed by a subsequent pregnancy within a 10-year span meeting study's criteria. Patients were in the study group if a TFB was used alone or in combination with prostaglandins and/or oxytocin for IOL while the control group did not include TFB. Age, race, BMI (in first pregnancy and subsequent pregnancy), tobacco use, previous LEEP, previous D&amp;C, indication for IOL, and birth weight (in first pregnancy and subsequent pregnancy) were all not significantly different between the groups. Bishop score was significantly higher in the control group (p=0.003). Mode of delivery for the initial pregnancy was significantly different between the two groups (p=0.019) with a higher rate of cesarean section in the study group. Mean gestational age at delivery of the subsequent pregnancy was 39 and 39.1 weeks for the control and study groups respectively (p=0.747). CONCLUSION: The use of TFB for IOL did not have an impact on gestational age of subsequent pregnancy when compared to other modes of induction. The cesarean section rate was higher in the TFB group in the initial pregnancy, which was likely related to the lower bishop score and increased difficulty of IOL which required the TFB in addition to the other methods to begin with.

Obesity Effect on Induction of Labor Duration [25R

INTRODUCTION: Obesity and associated morbidity significantly impacts obstetric management, including increased indication for induction of labor (IOL). Retrospective studies report obesity prolonging labor course. We aim to investigate duration of IOL stratified by body mass index (BMI). We hypothesize obesity prolongs IOL. METHODS: Prospective cohort study of singletons undergoing IOL. Obstetric management was per provider's discretion (vaginal misoprostol, cervical balloon, intravenous oxytocin). The primary outcome was interval from starting IOL to latent labor. Secondary outcomes include duration to active labor and delivery. Labor was considered prolonged if greater than 24 h to latent labor, and greater than 36 h to active labor. Patients were analyzed by BMI category (under 30, between 30 and 39.9, over 40 kg/m2). Cesarean delivery outcomes were excluded. Non-parametric and chi-square test were used for analysis. RESULTS: Total of 99 enrolled, 23 were delivered by cesarean, leaving 76 analyzed. The median BMI was 36 kg/m2 (19-75); 17 BMI under 30, 37 BMI between 30 and 39.9, 22 BMI over 40. The parity and Bishop's score were not significantly different. The BMI group median duration to latent labor (10.6 v 9.6 v 12.7 h, P=.5), to active labor (14.1 v 15.0 v 19.2 h, P=.5), and to delivery (18.5 v 17.8 v 20.6 h, P=.5) were not significantly different. The time to achieve active labor trended longer with increasing BMI (P=.049). CONCLUSION: Prospectively analyzed induced labor curves were not significantly different between normal weight, obese, and severely obese women. This provides evidence that, regardless of BMI, IOL is a viable management option.

Efficacy and Safety of Foley Catheter Balloon for Cervix Priming in Term Pregnancy.

Foley catheter promotes cervix priming by a direct mechanical effect of distension. A prospective observational study was conducted at a tertiary hospital, including all cases of induction of laborwith Foley catheter between September 1, 2013 and November 30, 2015. Women were eligible if they had a singleton pregnancy witha Bishop score < 6 and a gestational age ≥ 41 weeks or a medical indication for induction of labor. The primary outcome was the Bishopscore variation (difference between Bishop score before and after insertion of Foley catheter). Mode of delivery, induction-to-deliverytime, uterine tachysystole with fetal decelerations, peripartum fever ≥ 38º C, maternal pain and mortality were also analyzed. Within 201 inductions with Foley catheter, average increase in Bishop score after catheter placement was three (1 - 7), withonly 5% (11/201) of unmodified cervix after catheter removal/extrusion. Vaginal delivery rate was 71% (142/201) and in women with aprevious cesarean section (n = 40) was 37% (15/40). Average induction-to-delivery time was 38 hours (4 - 120). Uterine infection ratewas 3% (6/201). There was only one case of significant vaginal bleeding which required immediate catheter removal. There has beenno significative maternal or neonatal morbidity. Foley catheter is a safe and effective method of cervical priming for women with an unfavorable cervix, evenin the case of a previous cesarean delivery.