Abstract
Background: Ripening of cervix is a prerequisite for successful labour induction. Use of prostaglandins for this purpose incurs a high risk of uterine hyperstimulation and a relatively higher cost of treatment. intracervical Foleys catheter insertion is a mechanical method stated in literature. The present study was to compare the efficacy and safety and cost of intracervical Foleys catheter balloon insertion with intracervical dinoprostone application for preinduction cervical ripening in patients requiring labour induction at term.Methods: This was a randomized, parallel group, active controlled study conducted in the obstetrics department of a tertiary care centre over a duration of one year. Group A received Dinoprostone cervical gel 0.5mg instilled in the cervical canal. Maximum of three doses (1.5mg dinoprostone) could be administered 6 hours apart. Patients randomized to group B were subjected to Foleys catheter insertion. Foleys catheter number 16 was used and balloon was inflated with 60ml of water. Primary efficacy parameter was change in Bishops score as compared to baseline and safety was monitored by comparing the total number of adverse events in the two groups.Results: Total of 89 patients were enrolled into the study during one year period out of which 45 received dinoprostone gel and 44 received Foleys catheter insertion respectively. Change in Bishops score, mode of delivery and total number of maternal and foetal adverse events did not differ significantly between the two groups.Conclusions: Efficacy and safety of Foleys catheter as a cervical ripening agent prior to induction of labour is comparable to dinoprostone gel. Since use of Foleys catheter is advantageous in terms of lack of specific storage conditions and cost of treatment, it could be considered a cost effective alternative for preinduction cervical ripening.
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