Abstract

Background: The cervical condition at the time of induction determines whether or not labor induction is successful. Patients with low Bishop scores are expected to experience an unacceptably high rate of induction failure. The solution is cervical ripening using any approach to reduce induction failure. The objective of the study is to analyze the safety and efficacy of Transcervical Foley's catheter for cervical ripening in pregnant women with term gestation.
Methods: The study included n=200 patients after 38 completed weeks of gestation with a Bishop’s score <4 with various indications for induction were randomly allocated to receive n=100 patients with transcervical Foley’s catheter and n=100 patients to receive intracervical prostaglandin E₂. In the Foley group, 12 hours after insertion of the catheter, it was deflated and removed, and rescoring of the cervix was carried out for improvement in the bishop's score. In the Dinoprostone group, Bishop's score was reassessed after 6 hours. If the bishop score was poor, the same dose of PGE₂ was repeated and reassessed after 6 hours for a maximum of 3 doses in 24 hours.
Results: The bishop score is assessed at 0 hrs in both the groups. The majority of patients had Bishop scores of 0- 2. In Foley's group, n=62 cases and the PGE₂ gel group to n=56 cases had Bishop scores in the range 0-2. There was no statistical significance between the two groups.  At 6 hrs only Dinoprostone group patients were reassessed according to protocol. The majority of patients in the Dinoprostone group show Bishop scores of 5-7 at 6hrs. The bishop score is assessed at 12hrs in both groups. In Foley's group n=42 cases and in Dinoprostone group, n=31 cases had delivered within 12 hrs and hence were not assessed. Majority of patients in both the groups showed bishop’s scores of 5 – 7 at 12 hours.
Conclusion: Foley's catheter is an equally effective method for pre-induction cervical ripening as Prostaglandin E₂ gel in terms of initial cervical score, improvement in cervical
score, the success of induction, and the induction delivery intervals. The use of a Foley catheter was equally acceptable to the patients as the prostaglandin gel.