Title: The Efficacy of Transcervical Foleys Catheter with Extra Amniotic Saline Infusion in Cervical Ripening Before Induction of Labour with Vaginal Prostaglandins

Authors: Dr Patsy Varghese, Dr Lakshmi .B.S, Dr Neethu Rani

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i4.12

Abstract

Aim: To evaluate the efficacy of transcervical Foley catheter with extra amniotic saline infusion in cervical ripening before induction of labour with intravaginal prostaglandin E1.

Methodology: 106 patients with cephalic presentation, singleton pregnancy with intact membranes having modified Bishop’s score < /= 2 were selected. They were randomly divided in to two groups of 53 each. In group A Foley catheter with extra amniotic saline infusion was given for cervical ripening before the induction of labour with intravaginal PG E1 and in group B , PG E1 was given intravaginally without using Foley and extra amniotic saline infusion. Induction to delivery interval was calculated from the time when the intravaginal PG E1 is kept.

Results: There was significant improvement in modified Bishop score after Foley catheter expulsion in group A. The mean induction to delivery interval was significantly shorter and rate of vaginal delivery within 24 hours was significantly higher when compared to group B. There was no significant difference in mode of delivery, intra partum complications, rate of ARM, oxytocin use or neonatal outcomes.

Conclusion: Intra cervical Foley catheter with extra amniotic saline infusion is an effective method for cervical ripening in women with very unfavourable cervices.

Keywords: Induction of labour, Foley catheter, Prostaglandin E1, Modified Bishop’s score. 

References

1.      AT OwolabiOK ,IO Ogunlola. Rando-mised trial of intravaginal misoprostol and intracervical Foley catheter for cervical ripening and induction of labour . J Obstet Gynaecol.2005;25(6):565-8.

2.      Sanchez – Ramos L. Induction of labour .Obstet Gynecol Clin N Am. 2005;32:181-200.

3.      TenoreJL . Methods for cervical ripening and induction of labour. American Family Physician .2003 ; 67(10).

4.      Kandil MEM, SayyedT ,Masood A. Foley catheter versus intra vaginal misoprostol for induction of labour in post- term gestations. Arch GynecolObstet. 2012;286 (2):303-7.

5.      James CPA, Seshadri L. Use of Foley catheter as a cervical ripening agent prior to induction of labour. Int J Gynecol Obstet. 1994;47(3):229-32.

6.      Carbone JF, Fogertey PJ, Roehl KA, Macones GA. Combination of Foley bulb and vaginal misoprostol compared with vaginal misoprostol alone for cervical ripening and labour induction: a randomized controlled trial. Obstet Gynecol. 2013;121:247-52.

7.      Chung JH, RumneyPJ, Garite TJ, Nageotte MP. A prospective randomized controlled trial that compared misoprostol, Foley catheter and combination misoprostol – Foley catheter for labour induction. Am J Obstet Gynecol. 2003;189:1031-5.

8.      Kashanian M, Fekra M. Cervical ripening and induction of labour with intravaginal misoprostol and Foley catheter cervical traction. Int J Gynecol Obstet. 2005;96:79-80.

Corresponding Author

Dr Lakshmi .B.S

Assistant Professor, Dept. of Obstetrics and Gynaecology

Govt. Medical College, Thiruvananthapuram