Cervical ripening with the Foley catheter.
OBJECTIVE
To evaluate maternal and neonatal outcomes in a large series of patients undergoing cervical ripening with a Foley catheter.


METHODS
The database of the Labor and Delivery Unit of the University of a teaching hospital in Italy was used to identify consecutive patients with a Bishop score (BS) of 4 or less who underwent pre-induction cervical ripening with a Foley catheter. The main outcome measures were clinical chorioamnionitis, endometritis, and suspected and culture-proven neonatal sepsis.


RESULTS
Of 602 women undergoing cervical ripening with a Foley catheter, 160 (26.6%) went into active labor without additional interventions. Oxytocin was administered immediately after removal of the Foley catheter in 188 (31.2%) of the women, and 254 (42.2%) required an application of prostaglandin E2 vaginal gel. The cesarean delivery rate was 25.6%. The median time to delivery was 1469 min (range, 94-3350 min). Of the women who gave birth vaginally, 225 (50.2%) were delivered within 24 h. Clinical chorioamnionitis and postpartum endometritis occurred in 3 (0.5%) and 6 (1.0%) of the women, respectively. Neonatal sepsis was suspected in 4 (0.7%) of the newborns but blood culture results were negative in all cases.


CONCLUSIONS
Transcervical use of the Foley catheter is safe for pre-induction cervical ripening, and the associated risk of maternal or perinatal infections is negligible.
Cromi
A
A
Department of Obstetrics and Gynecology, University of Insubria-Ospedale F. Del Ponte, Varese, Italy. antonellacromi@libero.it
Ghezzi
F
F
Tomera
S
S
Uccella
S
S
Lischetti
B
B
Bolis
P F
PF
D000293:Adolescent; D000328:Adult; D002404:Catheterization / Q000009:adverse effects / Q000379:methods*; D020070:Cervical Ripening; D002821:Chorioamnionitis / Q000209:etiology; D004716:Endometritis / Q000209:etiology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007747:Labor Stage, First; D007751:Labor, Induced / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D008875:Middle Aged; D007744:Obstetric Labor Complications / Q000628:therapy*; D011247:Pregnancy; D012189:Retrospective Studies; D016896:Treatment Outcome