Ali F Al-Assadi
FICOG, CABOG. Assist. Prof., Dept. of obstetrics & gynecology, Basrah Medical College.
This study aimed to compare the efficacy of two methods (extra-amniotic saline instillation and
extra-amniotic misoprostol) for ripening the unfavorable cervix.
The study was set at the labour room in Basrah Maternity (teaching) hospital with 300 bed
It is a prospective comparative study conducted to compare extra-amniotic saline instillation
and extra-amniotic Misoprostol for ripening the unfavorable cervix.
Group I (Extra-amniotic saline instillation): Foley’s catheter with extra-amniotic normal saline
instillation at a rate of 1ml/min.
Group II (extra-amniotic Misoprostol): The cervix was ripped with 25mcg. Misoprostol injected
extra-amniotically using a Foley’s catheter.
The clinical trial involved a total (121) pregnant women, in group I (57) and in group II (64). The
success rates in achieving cervical ripening were 100% for both groups. The mean post ripening
Bishop’s score in group II (primigravidae (7.5 ± 1.5), multigravidae (7.86 ± 1.39)) were
significantly higher than those in group I (primigravidae (6.01±0.4), multigravidae (6.07± 0.47)).
The mean ripening time (hrs) in group II (primigravidae (6.15± 2.1), multigravidae (4.03± 1.3))
were significantly shorter than those in group I (primigravidae (7.71± 1.02), multigravidae (6.4±
1.02)). The mean induction-delivery time (hrs) in group II (primigravidae (5.3± 2), multigravidae
(3.8± 1.4)) were significantly shorter than those in group I (primigravidae (7,7± 2.03),
multigravidae (5.92± 1.9)). The vast majority of women under study had vaginal delivery (80.7%
in group I and 96.8% in group II).
In conclusion, EAM was quick and effective method for ripening the cervix, it requires little
training for application so that it is a suitable method for patients who require rapid induction of