INDUCTION OF LABOR

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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A study comparing vaginal misoprostol alone with vaginal misoprostol in combination with Foley catheter for cervical ripening and labour induction

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20170367 ◽

2017 ◽

Vol 6 (2) ◽

pp. 485 ◽

Cited By ~ 2

Author(s):

Binti R. Bhatiyani ◽

Manisha R. Gandhewar ◽

Swati Kapsikar ◽

Pradip Gaikwad

Keyword(s):

Foley Catheter ◽

Active Phase ◽

Fetal Distress ◽

Induction Of Labor ◽

Cervical Ripening ◽

Labour Induction ◽

Combination Group ◽

Maternal Complications ◽

Misoprostol Group ◽

Vaginal Misoprostol

Background: Induction of labor is a commonly practised intervention in modern obstetrics. The objective of this study was to compare the efficacy of vaginal misoprostol alone with vaginal misoprostol in combination with Foley catheter for labour induction. It aims to assess the induction delivery interval, the outcome of labour, the incidence of instrumental delivery and Cesarean section. The neonatal outcomes and maternal complications would also be assessed.Methods: 105 women with singleton viable pregnancies of 28 weeks or more gestation with cephalic presentation, intact membranes and an unfavorable cervix (Bishops score less than 6) were randomly assigned to induction of labor using vaginal misoprostol or Foley catheter in combination with vaginal misoprostol. Women in the misoprostol only group received 25 micrograms of misoprostol per vagina every 4 hours for a maximum of six doses. Whereas women in the combination group received vaginal misoprostol and in addition Foley catheter was introduced through the cervix for 12 hours. Interruption of the trial was done in case of failure to enter the active phase of labour after 24 hours of induction, fetal distress, hyperstimulation, hypersensitivity to drugs.Results: The induction to delivery time was shorter in misoprostol group as compared to the Foley with misoprostol group by 3 hours. There was no significant change in Bishops score after induction with Foley in combination with misoprostol as compared to misoprostol alone. There was no increase in the maternal and fetal complications in the misoprostol group as compared to Foley with misoprostol.Conclusions: Misoprostol alone was more efficacious for ripening and inducing agent as compared to Foley in combination with misoprostol.

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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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310: A prospective randomized study comparing induction of labor with the foley catheter and the cervical ripening double balloon catheter in nuliparous and multiparous women

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2009.10.325 ◽

2009 ◽

Vol 201 (6) ◽

pp. S124 ◽

Cited By ~ 5

Author(s):

Ido Solt ◽

Shani Ben-Harush ◽

Svetlana Kaminsky ◽

Vladimir Sosnovsky ◽

Ella Ophir ◽

...

Keyword(s):

Randomized Study ◽

Foley Catheter ◽

Balloon Catheter ◽

Induction Of Labor ◽

Cervical Ripening ◽

Prospective Randomized Study ◽

Double Balloon ◽

Multiparous Women

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Oral Misoprostol Versus Vaginal Prostaglandin E2 Labor Induction Efficiency, Safety, and Labor Outcomes

International Journal of Childbirth ◽

10.1891/2156-5287.9.2.63 ◽

2019 ◽

Vol 9 (2) ◽

pp. 63-68

Author(s):

Areefa S. M. Alkasseh ◽

Muyassar El-Jazzaranal ◽

Doaa Abu Khadijah ◽

Fatma Al-Derbaly ◽

Reem Al-Nemnum ◽

...

Keyword(s):

Gaza Strip ◽

Mode Of Delivery ◽

Fetal Distress ◽

Labor Induction ◽

Induction Of Labor ◽

Cervical Ripening ◽

Prostaglandin E ◽

Birth Canal ◽

Delivery Outcome ◽

Oral Misoprostol

BACKGROUNDProstaglandin E1 (oral misoprostol) and the other Prostaglandin E2 (Dinoprostone gel) are promising agents for cervical ripening and induction of labor.AIMS OF STUDYTo compare the efficiency and safety on maternal-fetal outcomes using 25 micrograms oral misoprostol PGE1 with 50 micrograms of intra-vaginal PGE2 for induction of labor.METHODSThis was a retrospective study design reviewing medical records of induced labor at Al Shifa hospital in Gaza Strip.RESULTSIn general, the results showed that women who used oral misoprostol with an age less than 30 years and parity less than 3 was effective for delivery and safe outcomes with an odds ratio (OR) of 15.8 (CI 6.9–39.8) and OR 29.2 (CI 10.7–80.3) respectively. The most common indication for labor induction in both methods was reputure of the membrane (ROM) more than 24 hours, postdates, and a medical disorder. However, the total interval hours for both methods was 8.4 hours. The mode of delivery was similar in both groups as vaginal delivery outcome was 73.6% for oral misoprostol E1 and 75% for prostaglandin E2 cases. However, PGE2 induction showed a higher cesarean delivery 25% rate versus 18.4%. Clinically the use of oral misoprostol showed a higher percentage of birth canal injury, failed induction, uterine rupture by 9.3%, 8%, 1.3% respectively. Fetal distress was found as the most common fetal complication and the most common cause for cesarean section.CONCLUSIONThe study recommended more research is needed as present evidence does not support use of oral misoprostol versus Prostaglandin E2.

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Prostaglandin E2 Cervical Ripening Without Subsequent Induction of Labor

Obstetrics and Gynecology ◽

10.1097/00006250-199907000-00003 ◽

1999 ◽

Vol 94 (1) ◽

pp. 11-14 ◽

Cited By ~ 1

Author(s):

DAVID S. MCKENNA ◽

STEPHANIE W. COSTA ◽

PHILIP SAMUELS

Keyword(s):

Prostaglandin E2 ◽

Induction Of Labor ◽

Cervical Ripening

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

European Journal of Obstetrics & Gynecology and Reproductive Biology ◽

10.1016/s0301-2115(00)00544-3 ◽

2001 ◽

Vol 97 (2) ◽

pp. 183-187 ◽

Cited By ~ 12

Author(s):

Fabio Ghezzi ◽

Franchi Massimo ◽

Luigi Raio ◽

Edoardo Di Naro ◽

Debora Balestreri ◽

...

Keyword(s):

Prostaglandin E2 ◽

Foley Catheter ◽

Cervical Ripening

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Randomized, double-blind trial of prostaglandin E2 intravaginal gel versus low-dose oxytocin for cervical ripening before induction of labor

American Journal of Obstetrics and Gynecology ◽

10.1016/s0002-9378(96)70228-4 ◽

1996 ◽

Vol 174 (6) ◽

pp. 1910-1916 ◽

Cited By ~ 16

Author(s):

Dean M. Pollnow ◽

Fredrik F. Broekhuizen

Keyword(s):

Prostaglandin E2 ◽

Low Dose ◽

Induction Of Labor ◽

Cervical Ripening ◽

Double Blind Trial ◽

Double Blind ◽

Blind Trial

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A comparative study of intra-cervical foley’s catheter and PGE2 gel for induction of labour at term

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20193799 ◽

2019 ◽

Vol 8 (9) ◽

pp. 3689

Author(s):

Anjali R. Kanada ◽

Mahima Jain

Keyword(s):

Side Effects ◽

Caesarean Section ◽

Comparative Study ◽

Foley Catheter ◽

Induction Of Labour ◽

Cervical Ripening ◽

Labour Induction ◽

Mechanical Methods ◽

Significant Difference ◽

Foley’S Catheter

Background: In cervical ripening, before induction of labour, is needed to increase the success of labour induction, to reduce complications and to diminish the rate of caesarean section and duration of labour. Pharmacological preparations are in widespread use for cervical ripening but are not free from side-effects and complications. Mechanical methods, i.e. the use of Foley’s catheter balloon, though effective have not gained much popularity because of the fear of infection. Therefore, the study has been conducted to prove the efficacy and safety of extra amniotic Foley catheter balloon and to compare it with intra-cervical prostaglandin E2 (PGE2) gel. The objective of the study was to the success of induction of labor depends on the cervical status at the time of induction. For effective cervical ripening both Foley's catheter and PGE2 gel are used. The aim of this study was to compare the efficacy of intra cervical Foley's catheter and intra cervical PGE2 gel in cervical ripening for the successful induction of labor.Methods: A randomized, comparative study was conducted in the department of obstetrics and gynaecology, Civil hospital, B.J. Medical College Ahmedabad, during a period of 8 month from September 2018 to April 2019. 100 patients at term with a Bishop's score ≤5 with various indications for induction were randomly allocated to group F (intra-cervical Foley’s catheter) and group P (PGE2 gel) with 50 women included in each group.Results: The groups were comparable with respect to maternal age, gestation age, indication of induction and initial Bishop's score. Both the groups showed significant change in the Bishop's score, 5.10±1.55 and 5.14±1.60 for Foley's catheter and PGE2 gel, respectively, p <0.001. However there was no significant difference between the two groups. There was no significant difference in the side effects and caesarean section rate in both groups. The induction to delivery interval was 16.01±5.50 hours in group F and 16.85 ± 3.81 hours in group P (p=0.073). Apgar scores, birth weights and NICU admissions showed no significant difference between the two groups.Conclusions: The study shows that both Foley's catheter and PGE2 gel are equally effective in pre induction cervical ripening.

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