Efficacy of Vaginal Misoprostol and Intracervical Catheterization in Labour Induction for Vaginal Delivery in Eclampsia Patients

Background: Eclampsia, a severe complication of pregnancy characterized by seizures, remains a significant cause of maternal and neonatal morbidity and mortality. Effective and safe labor induction methods are crucial for managing eclampsia, particularly in resource-limited settings. This study compares the efficacy and safety of vaginal misoprostol and intracervical Foley’s catheterization for labor induction in eclamptic patients. The aim of the present study was to compare the vaginal misoprostol and intracervical catheterization to induce labor in eclamptic patients. Material & Methods: This prospective randomized clinical trial was conducted at the Eclampsia unit of Dhaka Medical College & Hospital, Bangladesh. Sixty antepartum eclamptic patients were enrolled with 30 receiving vaginal Misoprostol (25µg every 6 hours for 24 hours) and 30 undergoing intracervical Foley’s catheterization. The study assessed induction-delivery interval, mode of delivery and maternal and neonatal complications. Baseline characteristics including age, socioeconomic status, gravidity, gestational age and Bishop’s Score were recorded. Results: The induction to active labor interval averaged 9.13 ± 3.45 hours for the Misoprostol group and 10.27 ± 3.26 hours for the Catheterization group (p=0.197). Active labor to delivery times were 6.48 ± 4.20 hours and 5.67 ± 5.79 hours respectively (p=0.566). Total induction to delivery times were comparable at 15.48 ± 5.02 hours for Misoprostol and 15.92 ± 6.12 hours for Catheterization (p=0.771). Vaginal delivery was achieved in 76.67% of the Misoprostol group and 83.33% of the Catheterization group. Complication rates including tachysystole (10% vs. 6.67%), uterine hyperstimulation (3.33% vs. 0%) and maternal fever (6.67% vs. 3.33%), were similar in both groups. Neonatal outcomes such as mortality (36.67% vs. 30%) and NICU admissions (36.67% vs. 30%) showed no significant differences. Conclusion: Both vaginal misoprostol and intracervical Foley’s catheterization are equally effective and safe for labor induction in eclampsia with comparable induction times, delivery outcomes and complication rates. These findings are significant for resource-limited settings, guiding clinical decisions in labor induction for eclamptic patients.