Abstract
OBJECTIVE: Both prostaglandin E 2 gel and an intracervical balloon catheter have been shown to be effective for cervical ripening. The purpose of this study is to compare the efficacy of intracervical prostaglandin E 2 gel with an intracervical Foley catheter for preinduction cervical ripening. STUDY DESIGN: A randomized, prospective study was conducted in the Maternity Care Center at the Foothills Hospital at Calgary, Alberta, Canada. Patients with a Bishop score ≤4 and meeting inclusion and exclusion criteria were included. Thirty patients were randomized to receive prostaglandin E 2 gel and 36 to receive an intracervical Foley catheter on the evening before induction. Induction then proceeded thue following morning by the preferred method of the attending physician. RESULTS: The groups were comparable with respect to maternal age, parity, gestational age, reason for induction, and initial Bishop scores. Both groups had a significant change in Bishop score (4.1 ± 0.4 and 4.8 ± 0.5, respectively, p < 0.001); however, there was no significant difference between the groups There was no significant difference in side effect profile, intrapartum complications, or delivery mode. Six cesarean sections (17.6%) were performed in the Foley group and seven (25%) in the prostaglandin E 2 gel group (not significant). The induction-to-delivery interval was 16.0 ± 1.7 hours in the Foley group and 21.5 ± 3.2 hours in the prostaglandin E 2 gel group ( p = 0.014). Apgar scores, cord gases, and neonatal birth weight showed no difference between the group. CONCLUSION: This study has shown that for preinduction cervical ripening there is no difference in efficacy between intracervical prostaglandin E 2 gel or an intracervical Foley catheter.
Published Version
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