randomized comparision of foley catheter insertion versus frostaglandin E[2] vaginal pessary for induction of labour in post date pregnancy

ABSTRACT

To see the safety and efficacy of cervical Foley catheter insertion in post date pregnancy, for induction of labour, as compared to prostaglandin E[2] vaginal pessary. A comparative, cohort study. The study was conducted in the department of obst / Gynae MH Rawalpindi from Sep 2003 to Sep 2004. There were hundred subjects in each group including both primigravidas and multigravdas upto para 3 with singleton pregnancy, postdates 6-10 days, age 20-30 years, Bishop score 3-6 with adequate pelvis. Sampling technique was convenient, non probability. In primigravidas improvement in Bishop Score after 06 hours was similar in both Group A [Foley catheter] [32%] and Group B [Prostin E[2]] [30%]. While in multigravidas improvement in Bishop Score was more in foley catheter in Group A [36%] as compared to Group B [24%]. The induction delivery interval was 12 hours in 69% cases of Group A and 67% cases of Group B [p< .001]. In Group A 80% patients were delivered by spontaneous vaginal delivery, 9% were delivered by lower segment ceasarian section [LSCS]. Where as in Group B 76% patients were delivered by spontaneous vaginal delivery, 11% were delivered by lower segment ceasarian section [LSCS]. There were 4 cases of non progress of labour, 4 cases of fetal distress, 2 cases of meconium aspiration and 1 case of uterine hyperfunction in Group A. However there were 5 cases of fetal distress, 3 cases of meconium aspiration, 3 cases of uterine hyperfunction and 1 case of uterine rupture in Group B. A good cervical preparation was achieved with Foley catheter by mechanical effect of the distended balloon and by release of endogenous PGE[2] comparable to extra amniotic PGE[2]. The readily available Foley catheter was inexpensive and there were no maternal systemic side effects