comparison of supracervical foley catheter, prostaglandin E2 tablet and combination of foley catheter and prostaglandin E2 tablet for cervical ripening and labor induction

ABSTRACT

The purpose of this study is to compare the efficacy and safety of supra-cervical Foley Catheter and vaginal prostaglandin E[2] [PGE[2]] tablet and combination of supracervical Foley Catheter and PGE[2] tablet for cervical ripening and labor induction. 90 patients admitted for induction of labor with a Bishop score catheter under traction [Foley group] or PGE[2] tablet vaginally [prostine group] or a combination of both [Foley + Prostine group]. Repeated insertion of prostine tablet after 8 hours was done if Bishop score was <7 in the last two groups. Oxytocin induction in the Foley group commenced once the catheter fell out spontaneously while in both the Prostine group and the Foley + Prostine group, after cervical ripening if regular uterine contractions were not achieved within 4 hours after the last PGE[2] tablet. No statistically significant differences were noted between groups in change in Bishop score, preinduction cervical ripening time and total induction time. Contractile abnormalities were more frequent in the Prostine group [20%] and the Foley + Prostine group [10%] than the Foley group [0%] [p=0.036]. There were no significant difference in mode of delivery or adverse neonatal outcomes. This study has shown that for preinduction cervical ripening, the Foley catheter is as effective as the PGE[2] tablet with added advantage of safety and more economic price, the addition of PGE[2] tablet to the Foley catheter did not provide additional efficacy, however better safety through decreased incidence of contractile abnormalities probably due to decreased dosage of prostine tablet