***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE The purpose of this study was to determine the efficacy of combination intravaginal misoprostol and intracervical Foley catheter for  prelabor cervical ripening . STUDY DESIGN A prospect i ve , r and omized controlled trial was conducted . Women who were undergoing labor induction , with a singleton gestation > or=28 weeks and an unfavorable cervix ( Bishop score < or=6 ) , were assigned to one of three groups : ( 1 ) intravaginal misoprostol 25 mug every 3 hours , ( 2 ) intracervical 16F Foley catheter , or ( 3 ) combination misoprostol-Foley catheter . RESULTS Among 146 patients , 49 patients were assigned to misoprostol , 54 patients were assigned to Foley catheter , and 43 patients were assigned to combination therapy . There was no difference in vaginal delivery rates ( misoprostol , 63.3 % ; Foley , 57.4 % ; combination , 58.1 % ; P=.81 ) . There were also no statistically significant differences in the interval between induction to active phase , active phase to delivery , or induction to delivery among the three groups . CONCLUSION Intravaginal misoprostol and intracervical Foley catheter are comparable for preinduction cervical ripening . The combination of the two methods did not provide additional efficacy OBJECTIVE The purpose of this study was to compare intravaginal misoprostol with extra-amniotic saline solution infusion with concomitant oxytocin for cervical ripening and labor induction in  viable pregnancies .  STUDY DESIGN Two hundred women with indications for labor induction and unfavorable cervices were assigned r and omly to vaginal misoprostol or extra-amniotic saline solution infusion . Twenty-five micrograms of misoprostol was administered every 4 hours up to six doses , followed by intravenous oxytocin administration . Patients who had received  extra-amniotic saline solution infusion also received intravenous oxytocin along with a maximum 12-hour saline solution infusion through Foley catheters that were placed above the internal cervical os . RESULTS One hundred women were r and omly assigned to misoprostol , and 100 women were assigned r and omly to extra-amniotic saline solution infusion . The average interval from start of induction to vaginal delivery was longer in the misoprostol group ( 1323.3 + /- 700.3 minutes ) than in the extra-amniotic saline solution infusion group ( 970.4 + /- 502.7 minutes ; P = .006 , log transformed data ) . Abnormal fetal heart rate tracings were found in 30 % of the patients who received misoprostol and in 19 % of the patients who received extra-amniotic saline solution infusion ( relative risk , 1.6 ; 95 % CI , 1.0 - 2.4 ; P = .05 ) . There was more tachysystole in the misoprostol group ( 8 % ) than in the extra-amniotic saline solution infusion group ( 1 % ; P = .02 ) . There were no differences in the routes of deliveries or neonatal outcomes between groups . CONCLUSION Extra-amniotic saline solution infusion with oxytocin administration appears more effective and is associated with fewer maternal complications than misoprostol for cervical ripening and labor induction OBJECTIVE Both prostagl and in E2 gel and an intracervical balloon catheter have been shown to be effective for cervical ripening . The purpose of this study is to compare the efficacy of intracervical prostagl and in E2 gel with an intracervical Foley catheter for preinduction cervical ripening . STUDY DESIGN A r and omized , prospect i ve study was conducted in the Maternity Care Center at the Foothills Hospital at Calgary , Alberta , Canada . Patients with a Bishop score < or = 4 and meeting inclusion and exclusion criteria were included . Thirty patients were r and omized to receive prostagl and in E2 gel and 36 to receive an intracervical Foley catheter on the evening before induction . Induction then proceeded the following morning by the preferred method of the attending physician . RESULTS The groups were comparable with respect to maternal age , parity , gestational age , reason for induction , and initial Bishop scores . Both groups had a significant change in Bishop score ( 4.1 + /- 0.4 and 4.8 + /- 0.5 , respectively , p < 0.001 ) ; however , there was no significant difference between the groups . There was no significant difference in side effect profile , intrapartum complications , or delivery mode . Six cesarean sections ( 17.6 % ) were performed in the Foley group and seven ( 25 % ) in the prostagl and in E2 gel group ( not significant ) . The induction-to-delivery interval was 16.0 + /- 1.7 hours in the Foley group and 21.5 + /- 3.2 hours in the prostagl and in E2 gel group ( p = 0.014 ) . Apgar scores , cord gases , and neonatal birth weight showed no difference between the groups . CONCLUSION This study has shown that for preinduction cervical ripening there is no difference in efficacy between intracervical prostagl and in E2 gel or an intracervical Foley catheter OBJECTIVE To assess the clinical efficacy of pharmacologic , mechanical and combination techniques of cervical ripening . STUDY DESIGN From March 1997 to August 1998 , all cervical-ripening patients at Lehigh Valley Hospital were r and omly assigned to three groups : intravaginal misoprostol , intracervical Foley catheter , or combination prostagl and in E2 ( PGE2 ) gel and Foley catheter .  Inclusion criteria included Bishop score < or = 5 and no contraindication to labor . The remaining delivery process was actively managed according to established guidelines . Multiple variables in perinatal outcome were analyzed , with the cesarean section rate and time from ripening to delivery as the main outcome variables . RESULTS Of the 205 patients , 65 were r and omized to the misoprostol group , 71 to the Foley group and 69 to the catheter- and -gel group . There were no differences between groups in delivery indications , maternal demographics , ultrasound findings , labor interventions , intrapartum times , mode of delivery , postpartum complications or neonatal outcomes . The misoprostol group demonstrated a higher rate of uterine tachysystole and required oxytocin less when compared to the two catheter groups . CONCLUSION The higher rate of uterine tachysystole with misoprostol did not increase the cesarean section rate . The higher rate of oxytocin required by the two catheter groups did not increase the delivery time intervals . There appears to be no benefit to adding intracervical or intravaginal PGE2 gel to the intracervical Foley balloon . The misoprostol and catheter ripening techniques have similar safety and efficacy The present r and omized controlled trial was undertaken to compare the safety and effectiveness of the transcervical Foley catheter with the application of intracervical dinoprostone for preinduction cervical ripening .  ( excerpt OBJECTIVE To compare the obstetric outcome of induction of labor at 41 weeks and of follow-up until 42 weeks and induction if the patient has still not given birth at 42 weeks . STUDY DESIGN Six hundred women at 287+/-1 days of gestation with definitely unfavorable cervical scores were r and omized to labor induction ( N=300 ) or spontaneous follow-up ( N=300 ) with twice-weekly nonstress testing and amniotic fluid measurement and once-weekly biophysical scoring . The treatments used in the induction group were ( 1 ) vaginal administration of 50 microg misoprostol ( n=100 ) , ( 2 ) oxytocin induction ( n=100 ) , and ( 3 ) transcervical insertion of a Foley balloon ( n=100 ) . The primary outcome measures were the cesarean delivery rate , whether or not the normal hospital stay had to be extended , and the neonatal outcomes . Secondary outcome measure included number of emergency cesarean deliveries performed for abnormalities of the fetal heart rate ( FHR ) . RESULTS The abdominal delivery rate was 19.3 % in the induction group and 22 % in the follow-up group ( p=0.4 ) . The mean length of hospital stay in the two main groups was 1.4+/-0.8 days and 1.3+/-1 days , respectively ( p=0.1 ) . Significantly higher rates of macrosomia and shoulder dystocia were seen in the follow-up group ( 24.6 and 2.3 % ) than in the induction group ( 7.6 % , p<0.001 ; 0.3 % , p=0.03 ) . Meconium-stained amniotic fluid and meconium aspiration syndrome were observed significantly less frequently in the induction group ( 9.3 and 1.3 % ) than in the follow-up group ( 20.3 % , p<0.001 ; 4 % , p=0.03 ) . Rates of emergency abdominal delivery in response to worrying FHR traces , neonatal intensive care unit admission , and low umblical artery pH were similar in the two groups . There was one intrauterine fetal death in the follow-up group . CONCLUSION Induction of labor at 41 weeks of gestation does not increase the cesarean delivery rate or cause a longer stay in hospital than follow-up until 42 weeks , and neonatal morbidity is also lower after induction OBJECTIVE Our purpose was to compare the efficacy and safety of misoprostol and extra-amniotic sodium chloride infusion with oxytocin for induction of labor . STUDY DESIGN This r and omized trial compared two methods of labor induction in women requiring cervical ripening . One hundred twenty-three women undergoing labor induction with a Bishop score < or = 5 were r and omly selected to receive either misoprostol , 50 microg intravaginally every 4 hours , or extra-amniotic sodium chloride infusion . The primary outcome variable was the time interval from induction to vaginal delivery . RESULTS Sixty-one women received extra-amniotic sodium chloride infusion and 62 women received misoprostol . The mean time interval from the start of induction to vaginal delivery was 15.0 + /- 5.0 hours and 16.5 + /- 7.2 hours for the extra-amniotic infusion and misoprostol groups , respectively ( P , not significant ) . The cesarean delivery rate was not significantly different between the 2 groups ( 32.8 % for the extra-amniotic infusion group ; 19.4 % for the misoprostol group ) . Maternal and neonatal outcomes were similar between the 2 groups . CONCLUSIONS Both methods of induction are equally efficacious and result in similar maternal and neonatal outcomes OBJECTIVES The aim of this study is to compare the effectiveness of the intracervical Foley balloon catheter and 3 mg prostagl and in E(2 ) tablet(s ) in preinduction cervical ripening . METHODS Ninety women referred to the maternity clinic for induction of labor with a Bishop score of less than or equal to 5 were r and omized to receive an intracervical Foley catheter or prostagl and in E(2 ) tablets . The primary measured outcome was ripening of the cervix as measured with the Bishop score . RESULTS There were no differences in mean Bishop scores between the prostagl and in and the Foley catheter groups . Bishop scores ( mean+/-S.D. ) after ripening were 6.6+/-0.80 and 6.7+/-0.86 for the Foley catheter and prostagl and in groups , respectively ( P=0.54 ) . The Foley catheter group showed a statistically shorter time to ripening compared with the prostagl and in group ( 3.4+/-2.1 and 6.5+/-3.2 h , respectively ( P=0.001 ) . There was no statistically significant difference in induction time ( 4.8+/-1.8 h and 5.3+/-2.4 h , respectively ( P=0.36 ) . CONCLUSIONS There are no differences in preinduction cervical ripening efficacy between prostagl and in E(2 ) and the Foley catheter , but the Foley catheter has the advantage of ripening an unfavorable cervix in a shorter time Objective To compare the cesarean rates in women undergoing induction of labor with unfavorable cervices who receive either misoprostol or extra-amniotic saline infusion .  Methods We assigned 250 women undergoing indicated induction of labor r and omly to misoprostol  ( 50 μg every 4 hours for three doses with or without oxytocin ) or extra-amniotic saline infusion and oxytocin .  Each eligible subject had a singleton gestation , vertex presentation , intact membranes , cervical dilation no more than 2 cm , and effacement no more than 50 % . Results Two hundred forty-eight women were studied after two exclusions ; 120 were assigned to misoprostol , and 128 to extra-amniotic saline infusion .  This sample size ensured an 80 % chance of detecting an intergroup difference in cesarean rates of at least two-fold . The groups were similar in age , race , parity , indication for induction , and gestational age . The extra-amniotic saline infusion group had a significantly lower median initial dilation ; however , at 12 hours , this group was significantly more dilated . The groups also were similar in epidural use , chorioamnionitis rates , endometritis rates , birth weights , and 
    Output:
    
We concluded that FCB and LAPG result in similar cesarean delivery rates , that FCB bears a higher risk of oxytocin use for labor induction and /or augmentation , and that LAPG carries a higher risk of contraction abnormalities