Abstract
Background: This study compared the efficacy and safety of the intracervical Foley catheter and dinoprostone insert for cervical ripening to achieve successful labor induction.
 Methods: This was a randomized controlled study conducted. 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. Primary efficacy parameter was change in Bishops score as compared to baseline.
 Conclusion: Our study showed that for pre induction cervical ripening there was no difference in efficacy between intracervical Foleys catheter and PGE2 gel.
 Keywords: Foleys catheter, Induction of labour, Prostaglandins
Highlights
Labor induction has become more widespread in most countries during the past decade, with 20% to 30% of all deliveries worldwide involving induced labor
Patients randomized to group B were subjected to Foleys catheter insertion
Our study showed that for pre induction cervical ripening there was no difference in efficacy between intracervical Foleys catheter and PGE2 gel
Summary
Labor induction has become more widespread in most countries during the past decade, with 20% to 30% of all deliveries worldwide involving induced labor. The administration of intra cervical prostaglandins (PGE2, PGF2) produce cervical change in pregnant women and become the standard method of ripening and induction of labour These pharmacologic agents are unstable and may have less potency if they are not stored properly. Intracervical Foleys catheter induction produces a mechanical distension of lower uterine segment, stripping the fetal membranes from decidua leads to activation of lysosomes and phospholipase –A, leading to formation of arachidonic acid which is later converted to PGs.[2] Mechanical stretching of cervix augments production of hyaluronic acid, which may enhance cervical swelling and softening Another potential mechanism enhancing cervical softening is the stimulation of inflammatory cytokine secretion, such as interleukins and MMPs. In addition, myometrial stretching increases expression of cyclooxygenase-2(COX-2) and Production of prostaglandins.[4]. Foleys is less costly PGE2 and has fewer side effect, reversibile and easy available.[5]
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