Inner thigh taping vs traction for cervical ripening with a Foley catheter: a randomized controlled trial

Abstract

To assess the effectiveness of inner thigh "Taping" compared with "Traction" using a weighted bag when an intracervical Foley catheter is used for cervical ripening. We performed a randomized controlled trial at a tertiary hospital on women with a singleton pregnancy in cephalic presentation admitted for labor induction with a Bishop score ≤6. A 30 mL intracervical Foley catheter was placed for ripening. Women were randomly allocated to inner thigh Taping or to Traction with a 500 mL weighted bag of fluid. The primary outcome was time to delivery. Secondary outcomes were time to expulsion of the catheter, maternal discomfort (visual analog scale), mode of delivery, and maternal morbidities. We randomized 197 women. After exclusions (4 ineligible, 2 withdrawn by provider), we analyzed 191 (96 Taping, 95 Traction) women in their assigned groups. Groups were similar regarding maternal race, age, parity, gestational age, and induction indication. Time to delivery was not significantly different (mean ± standard deviation: 19.8 ± 8.5 vs 18.8 ± 8.0 hours; P = .39). Time to catheter expulsion was shorter in the Traction Group (median, 2.6; range, 0.2-10.8 vs median, 1.5; range, 0.1-6.3 hours; P < .001). Change in Bishop and pain scores, cesarean delivery rates, clinical amnionitis, and other maternal morbidities were similar between groups. Subset analyses of those with vaginal delivery and among nulliparas, and multiparas revealed similar results. Traction on the intracervical Foley catheter during cervical ripening shortens the time to spontaneous catheter expulsion without affecting the time to delivery.