Three hundred ninety-seven women were assigned randomly to (1) Foley catheter left in place for a maximum of 24 hours, (2) Foley catheter left in place for a maximum of 12 hours, or (3) prostaglandin E2 controlled-release vaginal insert. Primary outcome was vaginal delivery within 24 hours.
There were no differences in vaginal delivery rates. The proportion of women who achieved vaginal delivery in 24 hours was lower in the 24-hour Foley catheter group than in the other 2 groups (24-hour Foley catheter, 21.0 % ; 12-hour Foley catheter, 59.8 % ; vaginal prostaglandin E2, 48.5 % ; P < .0001).
Cutting the ripening time with a Foley catheter by one-half increases the proportion of women who deliver vaginally within 24 hours and yields efficacy similar to that of prostaglandin E2 vaginal insert.