Extra-amniotic Foley catheter and prostaglandin E2 gel for cervical ripening at term gestation

background: Labor can be induced through a myriad of ways. The aim of this study was to compare the effectiveness of the intracervical Foley balloon catheter and intra vaginal 3 mg prostaglandin E2 tablet(s) in preinduction cervical ripening at term. Methods: Prospective analytic study of a cohort of 280 women selected through non probability sampling admitted in Obstetrics units, in two private hospitals one at Rawalpindi and the other at Mirpur (Azad Kashmir), from January 2009 to March 2010. All women were randomized to receive an intracervical Foley catheter or prostaglandin E2 tablets. The primary measured outcome was ripening of the cervix as measured with the Bishop score. Results: There were no differences in mean Bishop Scores between the prostaglandin and the Foley catheter groups. Bishop scores (mean ± S.D.) after ripening were 6.6±0.81 and 6.7±0.86 for the Foley catheter and prostaglandin groups, respectively (P=0.54). The prostaglandin group showed a statistically shorter induction to delivery time compared with the Foley catheter (16.5±2.2 and 20.51±3.89 h, respectively (P<0.01). Both the groups showed no statistically significant difference between the occurrences of spontaneous vaginal delivery. Labor was established in 72% cases of cervical Foley group. On the other hand induction occurred in 76% cases in prostaglandin group. There was no statistical difference between the need of oxytocin infusion for labor augmentation between the two groups and fetal distress was equally frequent in both the groups. Conclusions: Foley catheter was as effective as Prostaglandin E-2 at term for induction of labor with additional advantage of being cheaper, readily available and had no systemic side effects.

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Comparative study between transcervical extra-amniotic Foley’s bulb and prostaglandin E2 gel for pre-induction cervical ripening

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20205461 ◽

2020 ◽

Vol 10 (1) ◽

pp. 119

Author(s):

Prajakta Goswami ◽

Kapil Annaldewar ◽

Deepali Giri ◽

Sachin Giri

Keyword(s):

Prostaglandin E2 ◽

Vaginal Delivery ◽

Foley Catheter ◽

Induction Of Labor ◽

Cervical Ripening ◽

Normal Vaginal Delivery ◽

Bishop Score ◽

Group A ◽

Foley’S Catheter ◽

Group B

Background: Induction of labor is an artificial initiation of uterine activity before the spontaneous onset of labor with the aim of achieving vaginal delivery. Various pharmacological and non-pharmacological methods have been studied for the purpose.Methods: This randomized prospective study conducted in the Department of Obstetrics and Gynaecology at the Seth V. C. Gandhi & M. A. Vora Municipal General Hospital (Rajawadi Hospital), Mumbai from June 2019 to April 2020. It included pregnant patients admitted to the labor ward for induction of labor. A total 200 women were recruited and randomly allocated to the two study groups fulfilling the following selection criteria. Of these, 100 women were included in Foley's catheter group (group A) and 100 in (group B) prostaglandin E2 (PGE2) group. Results: The subjects included mainly were of 24-28 years age group. The period of gestation was 37-42 weeks in majority of the women in both the groups. Maximum numbers of women in both groups were primigravidae, being 66% in group A and 70% in group B. Foley catheter proved to be a highly effective pre-induction ripening agent for unfavorable cervix, compared to PGE2 gel, as evident by the mean Bishop score at 12 hours (p<0.05) and by the difference in change of Bishop score over 12 hours (p<0.05) in both groups A and B. Women in both the groups had a high rate of normal vaginal delivery, rate being significantly more in Foley’s group.Conclusions: This study concludes that extra-amniotic Foley’s catheter balloon is an effective, safe, simple, low cost, reversible, non-pharmacological mechanical method of pre-induction cervical ripening.

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