Transcervical foley catheter and oxytocin compared with transcervical foley catheter alone for induction of labour

Abstract

Objective: To evaluate whether transcervical Foley catheter with Oxytocin used concurrently for induction of labour (IOL) increases the delivery rate within 24 hours as compared to transcervical Foley catheter alone. Methodology: 220 women with Bishop score ≤6 undergoing IOL were randomized into a concurrent transcervical Foley catheter & Oxytocin group and a transcervical Foley catheter alone group and delivery rate ≤24 hours was assessed as primary outcome. Results: Of the 220 women who completed the trial, there were 110 subjects (52 nulliparae and 58 multiparae) randomized in each group. Delivery rate within 24 hours was > 95% in both groups (96.36% vs 95.45%, p=0.748). Oxytocin use was significantly longer in the concurrent group than in Foley alone group (10.50 vs 7.75 hours). Multiparae fared better than nulliparae in both the groups in terms of parameters like delivery rate within 24 hours (concurrent group: 100 vs 92.30%, p=0.046; & Foley only group: 98.27 vs 94.23%, p=0.342), delivery in 12 hours, caesarean sections, Foley expulsion time, oxytocin required and successful inductions. They also delivered much faster (combined group: 9 vs 12 hours; Foley only group: 9.41 vs 12.5 hours). Conclusion: Both methods- combined and Foley catheter alone is equally good for IOL. Concurrent use of oxytocin at the initiation of IOL exposes to a longer duration of oxytocin without expediting the induction thereby questioning oxytocin’s efficacy on the unprimed cervix. Thus concurrent methods (Foley & Oxytocin)) offers no extra advantage over the conventional methods (Foley alone) for IOL.