Abstract
Objective: The purpose of this study was to compare the efficacy of extra-amniotic Foley catheter with intra cervical Dinoprostone gel for preinduction cervical ripening. Study Design: A randomized, prospective study was conducted in the Department of Obstetrics and Gynecology, PGIMS Rohtak on 100 pregnant women admitted for induction of labor. Fifty patients were randomized to receive Dinoprostone gel and 50 patients to receive intracervical, extra-amniotic Foley catheter. Results: The two groups were comparable with respect to maternal age, parity, gestational age, indication for induction, and initial Bishop scores. Both groups had a significant change in Bishop score (4.18 ± 1.81 and 4.6 ± 1.48 respectively, p < 0.001); however, there was no significant difference between the groups. Mean duration of induction to delivery was 18.51 ± 8.52 in Foley catheter group and 18.21 ± 11.13 in prostaglandin group, the difference being statistically insignificant. Among 50 cases of prostaglandin only single dose was sufficient for 23 (46%) cases to induce labor. But in 27 (54%) cases 2nd dose of prostaglandin were required. The expenditure of intervention showed that Rs. 325 were required for induction by prostaglandin as compared to Rs. 60/- for Induction by Foley’s catheter and the difference was highly significant statistically There was no difference between the groups in mode of delivery, infant weight, apgar score and intrapartum complications. Conclusion: In conclusion, although both Foley catheter and dinoprostone gel appear to be effective agents for cervical ripening. Foley catheter causes less fetal distress, cheap and safety profile of Foley catheter is such that it can be used on an out patient basis, but not dinoprostone gel. These results make Foley catheter comparable or even superior to dinoprostone gel for cervical ripening specially in developing countries.
Highlights
The goal of obstetric is a pregnancy that results in a healthy infant and a healthy mother
The purpose of this study was to compare the efficacy of extra-amniotic Foley catheter with intra cervical Dinoprostone gel for preinduction cervical ripening
Fetal outcome data showed no significant difference between the Foley catheter and the prostaglandin gel groups with respect to birth weight, 1-minute apgar scores and 5-minute Apgar scores (Table 3)
Summary
The goal of obstetric is a pregnancy that results in a healthy infant and a healthy mother. The mechanical action of the Foley catheter strips the fetal membranes from the lower uterine segment and causes rupture of lysosomes in the decidual cells, part of which is phospholipase A. These lytic enzymes act on phospholipase to form arachidonic acid which is converted to prostaglandin, thereby improving the consistency and effacement of the cervix [9,10]. The advantage of this method over the pharmacological preparation includes simplicity of preservation, lower cost and reduction of side effects. Intracervical Foley catheter balloon with that of Dinoprostone gel for cervical ripening before induction of labour at term
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