Foley's catheter plus prostaglandin E[2] compared to prostaglandin E[2] alone for induction of labor

ABSTRACT

To compare the effectiveness of Foley catheter plus prostaglandin E[2] tablets with prostaglandin E[2] tablets alone in cervical ripening and induction of labor. Patients admitted for induction of labor were randomized into 2 groups. Group A received PGE[2] tablets and intracervical Foley catheter. Group B received PGE[2] tablets only. PG tablets were given to a maximum of 2 doses 6 hours apart. All patients had Bishop Score of <5 and no contraindication to vaginal delivery. After 12 hours, Bishop Score was assessed. Patients with favorable cervix [Bishop >/= 7] had artificial rupture of membranes. Syntocinon was started if there are no adequate uterine contractions. 300 patients participated in the study; 150 in each group. Bishop Score after 12hrs was significantly higher in group A compared to group B [7.48 +/- 1.72 Vs 6.09 +/- 1.85, p<0.01] as well as the mean change after 12 hours [3.20 +/- 1.59 Vs 2.37 +/- 1.42, p<0.01]. 14.4% of patients in group A had a Bishop Score of <7 after 12 hours compared to 25% in group B [p<0.05]. The induction to delivery time was significantly less in group A compared to group B [16.81 +/- 3.29 Vs 18.04 +/- 3.53,p<0.01]. Syntocinon was used in 68% of patients of group A compared to 81% of patients of group B [p<0.05]. 74% of group A patients delivered vaginally compared to 70.6% in group B, the difference was insignificant. There was no statistically significant difference regarding the number of C.S. and the number of instrumental deliveries as well. There was no significant difference regarding the incidence of fetal distress, puerperal pyrexia, or uterine hyperstimulation between the 2 groups. The combination of prostaglandin and Foley catheter resulted in better Bishop Score, shorter induction to delivery time, and fewer failed inductions. However, there was no significant effect on vaginal delivery or C.S. rates