Comparison of extraamniotic Foley catheter and intracervical prostaglandin E gel for preinduction cervical ripening.
BACKGROUND
The success of induced labor depends on the degree of ripening of cervix. 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 catheter balloon, though effective have not gained much popularity because of the fear of infection. Therefore, this study has been conducted to prove the efficacy and safety of extraamniotic Foley catheter balloon and to compare it with intracervical prostaglandin E2 (PGE2) gel.


METHODS
The randomized prospective study was conducted in the Department of Obstetrics and Gynecology and Medical Microbiology of Nehru Hospital. Hundred women attending the labor ward for induction of labor were divided into two groups: Group A--Foley catheter, Group B--PGE2 gel. Cervical swabs before and after the insertion of ripening agents were taken for culture studies. Placental membranes were also sent for culture. Labor outcome, side-effects, and complications were compared in both the groups. The statistical methods used were Student's compared t-test, Chi-square test, and Wilcoxon-Mann-Whitney test.


RESULTS
Foley catheter proved to be a very effective preinduction ripening agent for unfavorable cervix compared with PGE2 gel, as is evident by the mean Bishop score at 12 h (P<0.001). Preparation delivery interval was significantly shorter (P<0.05) in women who underwent cervical ripening with Foley catheter balloon than with the PGE2 gel. No clinical evidence of chorioamnionitis was present in both the groups.


CONCLUSIONS
This study concludes that extraamniotic Foley catheter balloon is an effective, safe, simple, low-cost, reversible, non-pharmacological mechanical method of preinduction cervical ripening.
Dalui
Rabindranath
R
Department of Obstetrics and Gynecology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Suri
Vanita
V
Ray
Pallab
P
Gupta
Indu
I
D000282:Administration, Intravaginal; D000328:Adult; D002404:Catheterization; D020070:Cervical Ripening / Q000187:drug effects*; D015232:Dinoprostone / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007751:Labor, Induced / Q000379:methods*; D010120:Oxytocics / Q000008:administration & dosage*; D011247:Pregnancy; D011446:Prospective Studies; D016896:Treatment Outcome; D014622:Vaginal Creams, Foams, and Jellies / Q000008:administration & dosage
D010120:Oxytocics; D014622:Vaginal Creams, Foams, and Jellies; D015232:Dinoprostone