Comparative characteristics of methods of pre-induction of labor in problematic cervix: A literature review
DOI:
https://doi.org/10.37800/RM.4.2025.502Keywords:
Pre-induction of labor, problematic cervix, misoprostol, Foley catheter, osmotic dilators, combined methods, prostaglandinAbstract
Relevance: A problematic (unprepared) cervix remains one of the main causes of ineffective labor induction. The study is aimed at a comparative analysis of the effectiveness and safety of the main methods of pre-induction of labor — mechanical, medicinal, and combined – with a problematic cervix. The article provides an overview of modern methods of labor induction for problematic cervix based on studies conducted from 2010 to 2024. Pharmacological methods (misoprostol and oxytocin), mechanical approaches (Foley catheter, osmotic dilators), and combined approaches are considered. A comparative analysis was carried out on efficacy, safety for mother and fetus, patient satisfaction level, and time before the start of active labor. Recommendations on the choice of the induction method are substantiated, depending on the clinical condition and preferences of the patient.
The study aimed to evaluate and compare the clinical efficacy, safety, and expediency of using mechanical, medicinal, and combined methods of pre-induction of labor in patients with an unfavorable condition of the cervix, based on the analysis of dynamics on the Bishop scale, birth outcomes, and complication rates.
Methods: The search involved scientific literature published in journals and websites from 2010 to 2023 concerning pre-induction and labor induction with problematic cervix.
The main inclusion criteria were the dynamics on the Bishop scale, the duration of the latent phase, the need for labor stimulation, the outcome of labor, and the frequency of complications.
Results: The combined group showed the highest efficiency: an increase in Bishop score ≥3 points in 88% of women. The mechanical method was less effective (60%), while the drug method was intermediate (75%).
Conclusion: Combined methods have demonstrated the greatest effectiveness and safety, which minimizes risks and increases patient comfort. The article highlights the importance of an individual approach to choosing an induction method to optimize labor outcomes.
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