Delivery Outcomes in Growth Restricted Babies Undergoing Induction of Labor with Misoprostol vs Foley Balloon

Document Type

Conference Proceeding - Restricted Access

Publication Date

5-8-2026

Abstract

Fetal growth restriction is a common complication of pregnancy and is most commonly defined as an estimated fetal weight or abdominal circumference of less than 10th percentile. A subset of this population, termed severe fetal growth restriction, is defined as estimated fetal weight or abdominal circumference less than the 3rd percentile. With the need to deliver these babies prior to spontaneous labor, the route of delivery is brought into question. Vaginal delivery is the ideal delivery method for both patient and fetus but the method of induction of labor varies and which method results in more vaginal deliveries is unknown. This study looks to compare rates of vaginal deliveries and cesarean sections using two methods of induction of labor; foley balloon or misoprostol.

This study is conducted as a retrospective chart review looking at incidence of cesarean sections and vaginal deliveries in FGR pregnancies induced with either misoprostol or foley balloons in patients who were admitted between January 2020 and January 2025. Summary statistics will be calculated for all study variables. Continuous variables will be expressed as mean ± standard deviation or median [25th, 75th percentile], depending on normality assessment. Categorical variables will be summarized as counts (percentages). Differences between induction groups (Foley Balloon vs. Misoprostol) will be assessed using a Chi-square test or Fisher's Exact Test for categorical variables. For continuous variables, Student's t-test will be used if data are normally distributed, while Wilcoxon Rank Sum Test will be used for non-normally distributed data. Statistical significance will be evaluated at the 0.05 level, with adjustments made if multiple comparisons are performed.

We hypothesize that fetal growth restricted pregnancies induced with foley balloon will have fewer incidences of cesarean section than induction with misoprostol. Currently we are still analyzing data but full results should be complete by research day. This study has the potential to change management strategies for fetal growth restricted pregnancies undergoing induction of labor and, if an association is found, could significantly improve obstetric maternal and fetal morbidity.

Comments

2026 Research Day Corewell Health West, Grand Rapids, MI, May 8, 2026. Abstract 1910

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