Please select the eligibility criteria that correspond to the clinical trial below.
Title: A Randomized Trial of Foley Bulb Induction With and Without Simultaneous Use of Oxytocin
Brief Summary: This study is considering current standard oxytocin dosing regimen in combination with Foley bulb for cervical ripening is associated with improved outcomes including greater percentage of women delivered within or less than 24 hours. The investigators will also assess other maternal and neonatal outcomes including risk of infection (i.e. chorioamnionitis), bleeding, uterine atony, cesarean delivery and use of regional analgesia.

Participants will be randomly assigned to one of the 2 arms of the study: use of oxytocin or no oxytocin while the Foley bulb is in place. As part of standard of care for inductions, Foley bulbs will be placed for all participants. Study participants who are randomly assigned to the use of oxytocin will receive oxytocin at the time the Foley bulb is placed. Study participants randomly assigned to no oxytocin will receive the oxytocin once the Foley bulb is removed.

After delivery, information will be collected from participant's chart on the outcome of pregnancy such as gestational age at delivery, type of delivery (vaginal or cesarean section), and baby's outcome (such as birth weight, APGAR scores, and any complications).


Options:
A: Inclusion Criteria:

1. Cervix \< 3 cm dilated. If 2cm dilated, must be \< 80% effaced.
2. Gestational age ≥ 36 weeks by best obstetric estimate, and clinical management decision is delivery.
3. Singleton gestation
4. Cephalic presentation

Exclusion Criteria:

1. Regular uterine contractions (more frequent than every 5 minutes)
2. PROM
3. Prior transverse uterine incision or any obstetric contraindication to labor
4. Fever (defined as a temperature of 38°C or higher)
5. Lethal fetal anomalies (Labor induction is being performed, but there is no plan for fetal heart rate monitoring or cesarean delivery for fetal indications.)
6. Fetal death
7. Placenta previa
8. Suspected placental abruption or undiagnosed bleeding characterized as more than "spotting"
9. Non-reassuring fetal heart rate pattern
10. HIV
B: Inclusion Criteria:

* women at \> 24 weeks gestation
* a non-anomalous, singleton fetus in a vertex presentation

Exclusion Criteria:

* history of prior uterine surgery such as cesarean section or myomectomy
* unexplained vaginal bleeding
* latex allergy
* contraindication to vaginal delivery (i.e. placenta previa, vasa previa, active vaginal bleeding, macrosomia etc)
C: Inclusion Criteria:

* Ongoing pregnancies with a live fetus in whom the decision has been made to induce vaginal delivery because of preeclampsia or uncontrolled hypertension. Women will be included irrespective of whether an intrapartum caesarean section on fetal grounds or would be considered or not.
* Women age ≥18 years
* Signed informed consent form

Exclusion Criteria:

* • Women with previous caesarean sections

  * Those unable to give informed consent
  * Multiple pregnancy
  * History of allergy to misoprostol
  * Ruptured membranes
  * Chorioamnionitis (by clinical diagnosis)
D: Inclusion Criteria:

* All women 18 years of age or greater
* singleton gestation
* vertex presentation
* 37 weeks gestational age or greater
* undergoing an IOL
* bishop score less than or equal to 6
* cervical dilation less than or equal to 2cm

Exclusion Criteria:

* All women less than 18 years of age
* Contraindication for vaginal delivery
* Prior cesarean delivery
* Multiple gestation
* Intrauterine fetal demise
* Fetal anomaly
* HIV
* Unable to consent/ non-English speaking
* Non-reassuring fetal heart rate
* Patients with hemolysis elevated liver enzymes and low platelets
* Eclampsia
* Intrauterine growth restriction (IUGR) 5th percentile with abnormal dopplers
* IUGR less than 10th percentile with reversed end diastolic flow
* Recurrent late decelerations w
* Continuous contractions more than 3 times in 10 minutes at onset of IOL (given that this is a contraindication to misoprostol use at our institution)
* Bishop score is greater than 6
* Cervical dilation greater than or equal to 2cm
* Confirmed ruptured membranes

Answer: B