Efficacy and Safety of Foley Catheter Balloon for Cervix Priming in Term Pregnancy.

Abstract

Foley catheter promotes cervix priming by a direct mechanical effect of distension. A prospective observational study was conducted at a tertiary hospital, including all cases of induction of laborwith Foley catheter between September 1, 2013 and November 30, 2015. Women were eligible if they had a singleton pregnancy witha Bishop score < 6 and a gestational age ≥ 41 weeks or a medical indication for induction of labor. The primary outcome was the Bishopscore variation (difference between Bishop score before and after insertion of Foley catheter). Mode of delivery, induction-to-deliverytime, uterine tachysystole with fetal decelerations, peripartum fever ≥ 38º C, maternal pain and mortality were also analyzed. Within 201 inductions with Foley catheter, average increase in Bishop score after catheter placement was three (1 - 7), withonly 5% (11/201) of unmodified cervix after catheter removal/extrusion. Vaginal delivery rate was 71% (142/201) and in women with aprevious cesarean section (n = 40) was 37% (15/40). Average induction-to-delivery time was 38 hours (4 - 120). Uterine infection ratewas 3% (6/201). There was only one case of significant vaginal bleeding which required immediate catheter removal. There has beenno significative maternal or neonatal morbidity. Foley catheter is a safe and effective method of cervical priming for women with an unfavorable cervix, evenin the case of a previous cesarean delivery.