Comparison of Labor Outcomes After Induction with Misoprostol Alone Versus Combined Misoprostol and Foley Catheter: A Retrospective Cohort Study from Riga Maternity Hospital

Background : Labor induction remains one of the most frequently performed procedures in obstetrics, primarily used when early delivery is associated with better maternal and fetal outcomes than pregnancy prolongation. Materials and Methods : This retrospective, comparative, observational study was conducted at Riga Maternal Hospital. In total, data of 4264 pregnant women were included in the study and were divided into two groups: 2892 women with misoprostol-only induced labor and 1372 women with the combined induction method. Results : Both primiparous and multiparous women had shorter times from the start of induction to the onset of labor and induction-to-delivery time in the combined method group. Primiparous women in the combined method group had a shorter labor duration and fewer labor episodes lasting 12 hours or more. No such relationship was found in multiparous women. The number of patients who underwent Cesarean section before the onset of labor was twice as high in the combined method group compared with the misoprostol-only group (2.2% vs 4.3%, p = 0.001). The overall Cesarean section rate did not differ significantly between the groups. Conclusion : The combined induction method significantly shortens the time from induction to the onset of labor and from induction to delivery compared with misoprostol. Additionally, there is no difference in Cesarean section rates between the methods, nor in maternal and perinatal short-term outcomes.