Induction of labour-An enigma,Concurrent versus sequential use of oral misoprostol plus foleys catheter for induction of labour.

Induction of labour is a widely used obstetric intervention, occurring in one in four pregnancies. When the cervix is unfavorable, different induction methods are used. Recently with steadily increasing  rates of induction , implementing effective and safe procedures at proper gestation of pregnancy can significantly decrease maternal and foetal complications. Different mechanical and medical methods are used to induce labour, but all of the existing methods are associated with medical risks. Therefore, while choosing labour induction  method, numerous aspects like cost effectiveness, safety, and rate of operative delivery should be considered. An informed consent will be taken. Consenting eligible women are enrolled in the study and randomized to either concurrent or sequential use of oral misoprostol and foley’s catheter. Clinical and demographic data is recorded. Favourability of cervix assessed with modified bishop’s score. For the concurrent group, foley’s catheter and oral misoprostol administration done on the same day . For the sequential group, foley’s catheter is introduced in the first day and oral misoprostol administration done on the next day. We compare primary outcome which is Induction to delivery interval and secondary outcomes such as vaginal delivery within 24 hours, number of doses needed to induce labour, need of oxytocin for augmentation of labour, caesarean section rate, maternal complications, neonatal complications and abnormalities in uterine contractility