title: Foley catheter for induction of labor: potential barriers to adopting the technique.
abstract: OBJECTIVE
  To evaluate if a learning curve exists for cervical Foley placement for labor induction in women with unfavorable cervices and whether labor curves differ compared with the dinoprostone insert (PGE2).
  
  
  METHODS
  We conducted a secondary analysis of a multicenter randomized controlled trial.
  
  
  RESULTS
  For Foley and PGE2, successful placement occurred in 157/185 (85%) and 188/191 (98%) women (P<0.001). Unsuccessful Foley placements decreased over time (P=0.005); all occurred at the site previously using PGE2 preferentially. In women with allocated agent placed successfully who achieved complete cervical dilation, median progress with Foley (n=112), compared with PGE2 (n=123), was: 1-3 cm (6.2 vs 14.1 h; P<0.001), 3-6 cm (11.1 vs 6.7 h; P<0.001) and 6-10 cm (1.9 vs 1.5 h; P=0.14).
  
  
  CONCLUSIONS
  There is a learning curve for placing cervical Foley catheters. Despite faster times to delivery, Foley is associated with slower dilation from 3 to 6 cm compared with PGE2.
authors.affiliation: Maternal-Fetal Medicine Division, Department of Obstetrics and Gynecology, Center for Women's Reproductive Health, Women and Infants Center, University of Alabama at Birmingham; Birmingham, AL, USA.
authors.forename: R K
authors.initials: RK
authors.lastname: Edwards
authors.affiliation: Maternal-Fetal Medicine Division, Department of Obstetrics and Gynecology, Center for Women's Reproductive Health, Women and Infants Center, University of Alabama at Birmingham; Birmingham, AL, USA.
authors.forename: J M
authors.initials: JM
authors.lastname: Szychowski
authors.affiliation: Phoenix Perinatal Associates; Maternal-Fetal Medicine; Obstetrix/Mednax; Phoenix, AZ, USA.
authors.forename: A V
authors.initials: AV
authors.lastname: Bodea-Braescu
authors.affiliation: Maternal-Fetal Medicine Division, Department of Obstetrics and Gynecology, Center for Women's Reproductive Health, Women and Infants Center, University of Alabama at Birmingham; Birmingham, AL, USA.
authors.forename: J R
authors.initials: JR
authors.lastname: Biggio
authors.affiliation: Phoenix Perinatal Associates; Maternal-Fetal Medicine; Obstetrix/Mednax; Phoenix, AZ, USA.
authors.forename: M G
authors.initials: MG
authors.lastname: Lin
mesh_terms: D000282:Administration, Intravaginal; D000328:Adult; D020070:Cervical Ripening / Q000187:drug effects*; D015232:Dinoprostone / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007751:Labor, Induced / Q000379:methods*; D059032:Learning Curve; D010120:Oxytocics / Q000627:therapeutic use*; D011247:Pregnancy; D014546:Urinary Catheterization / Q000009:adverse effects / Q000379:methods*; D055815:Young Adult
chemical_list: D010120:Oxytocics; D015232:Dinoprostone