Title: A Comparative Study of Intra-Cervical Foley’s Catheter and PGE2 Gel for Pre-Induction Cervical Ripening
Authors: Dr A.Rajeswari, Dr P.Sivaranjani
DOI: https://dx.doi.org/10.18535/jmscr/v5i8.53
Abstract
Background: To increase the success of labour induction, to reduce the complications and to diminish the rate of cesarean section and duration of labour, Cervical ripening is needed before the induction of labour. Even though pharmacological preparations are in widespread use for cervical ripening, it causes side-effects and complications. Foley’s catheter balloon (effective mechanical method) have not gained much attention because of infection. The efficacy and safety of extra amniotic Foley catheter balloon has been proved in this study by comparing it with intra-cervical prostaglandin E2 (PGE2) gel.
Objective: The success of induction of labour depends on the cervical status at the time of induction was analyzed in this study. For effective cervical ripening, Foley’s catheter and PGE2 gel are used in this work.
Further, the efficacy of intra cervical Foley's catheter and intra cervical PGE2 gel in cervical ripening for the successful induction of labour are compared and briefly elongated.
Methods: In the department of obstetrics and gynaecology a randomized, comparative study was conducted.
200 patients at term with a Bishop's score of ≤3 with various indications for induction were randomly allocated to receive (100 pts) intra-cervical Foley's catheter or PGE2 gel (100 pts) was taken in account during a period of one year from July 2015 to June 2016.
Bishop's score was noted, labor was augmented if required after 6 hours of post induction. Chi square test and t test was used for Statistical analysis in this work
Results: The groups were comparable with respect to maternal age, gestation age, indication of induction and initial Bishop's score. A significant change in the Bishop's score was showed by both the groups, 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.
In both the groups, no significant difference in the side effects and caesarean section was found. The induction to delivery interval was 16.01±5.50 h in group F and 16.85±3.81 h in group P (p = 0.073).There is no significant difference between the two groups in the aspects of Apgar scores, birth weights and NICU admissions.
Conclusion: This study shows that both Foley's catheter and PGE2 gel are equally effective in pre induction cervical ripening with better neonatal outcome with Foley’s catheter compared to that of PGE2 gel.
Keywords: Cervical ripening, PGE2, Foley's catheter, Induction of labour.
References
- World Health Organization. Department of reproductive health and research. WHO recommendations for induction of labour. Geneva, Switzerland: World Health Organisation; 2011:32.
- Tofatter KF, Bowers D, Standby RN, Gall A, Killam AP. ‘Pre-induction cervical ripening with prostaglandin E2 gel’. Am J Obstet Gynecol. 1985; 153:268-71.
- National institute for clinical excellence. Clinical guidelines for induction of labour, Appendix-E. London: NICE; 2001.
- Embrey, Mollison BG. ‘The unfavourable cervix and induction of labour using a cervical balloon’. BJOG. 1967; 74:44
- Sherman DJ, Frenkel E, Toblin J, Arieli S, Caspi E, Bukovasky I. ‘Ripening of the unfavourable cervix with extra-amniotic catheter balloon: clinical experience and review. Obstetrical and Gynecological Survey’. 1996;51(10):621-7.
- James C, Peedicayil A, Seshardi L. ‘Use of the Foley catheter as a cervical ripening agent prior to induction of labour’. International Journal of Gynecology and Obstetrics. 1994;47(3):229-32
- hu SK, Arora S. J Obstet Gynae India. 1984; 34:226.
- Sorensen SS, Brocks V, Lenstrup C. ‘Induction of labour and cervical ripening by intracervical prostaglandin E2’. Obstet Gynecol. 1985; 65:110-4.
- Ghanaei MM, Sharami H, Asgari A. Labour induction in nulliparous women: a randomized controlled trial of Foley catheter with extra amniotic saline infusion. J Turkish-German Gynecol Assocm. 2009; 10:71-5.
- Jaya R, Rani S. ‘Preinduction cervical ripening with endocervical PGE2 gel and a placebo control study. JObstet Gynecol India’. 1994;537-42.
- Jozwiak M, Bloemenkamp K, Kelly A, Mol B, Irion O, Boulvain M. ‘Mechanical methods for induction of labour’. Cochrane Database Systematic Rev 2012;(3):CD001233
- Dewan F, Ara AM, Begum A. ‘Foley's catheter versus prostaglandin for induction of labor’. Singap J Obste Gynaecol. 2001; 32:56-63
- Pennell C, Henderson J, O’Neill M, McCleery S, Doherty D, Dickinson J. ‘Induction of labour in nulliparous women with an unfavourable cervix: a randomised controlled trial comparing double and single balloon catheters and PGE2 gel’. BJOG. 2009; 116:1443-52.