Intra Cervical Foley Catheter as a Method for Induction of Labour : King Hussein Medical Centre Experience

Abstract

Aim of study: To assess the efficacy of using intra cervical Foley catheter induction of labour among pregnant women with and without previous caesarean section and their neonatal out come at King Hussein Medical Centre, Amman, Jordan. Material and methods: The study was conducted in the labor department of King Hussein Medical Center (KHMC) Amman, Jordan during the period from August 2013 to January 2014 using a data sheet including patient questionnaire to review demographic characteristics of patients, indication for induction of labor and results of inductions regarding outcome, success rate and neonatal outcome. During the study period (August 2013 to January 2014) a total of 200 patients were admitted for induction of labor and their data were reviewed. Results: The most prevalent age group of induced patients was (25 34 years) which accounts for (54.5%) followed by (16-24) which accounts for (30.5%); 15% only were between the age of 35 and 45. Booking status : A little more than half of the patients were booked (only 58.5%); more than half of our patients were either para one (39.5% of the cases) or primigravida (24.5%). Only 35 of the cases had previous one caesarian rate (17.5) and (82.5%) had previous normal deliveries. Most of the studied cases were below 41 weeks of gestational age where (53.0%) of the cases were between gestational age 40-41 week while post term were (10%) of cases and only (1.5%) were less than 34 weeks. Intra cervical Foley’s catheter was the most common used method for induction of labour, where more than half of our patients used this method (54.5%) followed by prostaglandin(23.0%). Artificial rupture of membranes followed by oxytocin or seeping of membranes was the least used method with each method accounting for around 10 %. The most common indication for induction of labour was post date (47.5%) followed by others (40.5%) which include (non reactive NST, isolated decreased fetal movement, oligohydromimious, unstable lie, Intra uterine fetal death IUFD, congenital abnormality of the fetus and bad obstetric history; maternal diseases represent (8.5%) of the cases. Pre eclampsia (PET) cases represented the majority of cases (70.5%) followed by Diabetes Mellitus (17.5%); only 2 cases were essential hypertension (12.0%). More than half of the cases of induction ended with vaginal deliveries (58%); instrumental deliveries were used in 5.5% of cases and in 72 cases the induction ended by caesarean section which represents (36%) of cases. Mode of delivery in patients with previous CS: 65.5% of those cases ended up with a second CS. Vaginal delivery was achieved in more than 34% of the cases : instrumental deliveries in (6%) and normal vaginal deliveries in (28.5%). Failure to progress represented the most common indication for C/S in pregnant women with previous C/S who underwent induction of labour (60%) followed by fetal distress (37%), while obstructed labour was reported in only one case. (3%) normal body weight was seen in (63%) of babies, good Apger score (8-9) was reported for 90% of the cases, with 3% had Apgar score less than 7. Conclusion: Induction of labor in still one of the major indications for admissions to the labor ward causing a lot of worries to both the patients, their family and the health care providers. Although the practice recommendation for the best method of induction especially for patients with previous uterine scar is still unclear, with a favor for use of prostaglandin preparation, our results suggested cervical Foley’s catheter as a reasonable alternative. More studies are needed to validate this option.