Cervical ripening and induction of labour: Inpatient or outpatient, oral misoprostol or Foley catheter? (original) (raw)
Background Induction of labor is defined as iatrogenic stimulation of uterine contractions to cause the delivery of fetus before the onset of spontaneous labour. An unfavorable cervix is a critical factor the obstetrician must overcome to improve the efficacy of induction of labor. At present, both medical and mechanical methods have been applied for cervical ripening in women with an unfavorable cervix. In developing countries like Ethiopia, conventionally cheap and feasible method used for preinduction cervical ripening is transcervical Foley’s catheter and misoprostol become practically important. So this study is designed to investigate the effectiveness of the most commonly ripening techniques (Foley catheter and vaginal misoprostol) in Gedeo zone. Method This is a quasi-experimental study to compare the effectiveness of Foley catheter and vaginal misoprostol for cervical ripening for labor induction. It was conducted in 120 pregnant mothers coming for induction who fulfil the ...
Mechanical Cervical Ripening with Foley Catheter Balloon: Rekindling a Forgotten Art
Journal of SAFOG, 2018
Introduction: Induction of labor is carried out in 20% of pregnancies in some countries. The success of induction of labor depends mainly upon the cervical ripening score. The most popularly used prostaglandins, misoprostol and dinoprostone, are effective in cervical ripening but have side effects of uterine hyperstimulation and fetal hypoxia, which may increase operative intervention and admissions to neonatal intensive care units. Mechanical dilatation is an age-old method that is safe and effective but lost its popularity with fear of chorioamnionitis. Aims and objectives: To study the efficacy and safety of Foley's catheter balloon as cervical ripening method when compared with misoprostol administered vaginally. Materials and methods: In this experimental study, 50 full-term patients with poor cervical score were included. They were divided into group I-those who received intracervical Foley and group II-those who received vaginal misoprostol. The cervical score was reassessed 24 hours later. Other variables like mode of delivery, fetal heart variability, and uterine hyperstimulation were also studied. Results: Both groups I and II showed improvement in cervical score. The occurrence of uterine hyperstimulation and fetal heart variabilities was less in group I. Conclusion: Mechanical cervical ripening with Foley's balloon catheter is as effective and safer compared with msoprostol when used for preinduction cervical ripening in full-term patients.
https://www.ijrrjournal.com/IJRR\_Vol.9\_Issue.1\_Jan2022/IJRR-Abstract039.html, 2022
Background: Cervical ripening essentially refers to the process of softening the cervix in order to make it prepare for the induction of labor. The success of labor induction depends on the cervical status at the time of induction. There are various methods of cervical ripening; however, in this study we will compare two famous methods of cervical ripening; Foley's cervical catheter and PGE2gel. Method: This prospective study was conducted at Lala-Ded Hospital, Srinagar from March 2016-September 2017. A total of 70 women fulfilling the defined inclusion criteria were enrolled for this study. They were randomly distributed into 2 groups, Group 1 (Foley's catheter group) and Group 2 (PGE2 gel group) with 35 women included in each group. Patients at term with various indications for induction of labor were included in the study after a comprehensive written consent. Result: The age distribution between the groups was insignificant. We observed that average gestational age was comparable in both the groups with a p-value of 0.526. However, the average post induction Bishop's score was significantly higher in group 1 compared to group 2with a p-value of 0.034. Conclusion: The present study demonstrated that even though both the methods of cervical ripening are effective but with Foley's intracervical catheter we witnessed a shorter induction delivery interval in comparison to PGE2 gel. Moreover, there was significant improvement in Bishop's score with Foley's catheter. Therefore, we suggest that in developing countries with limited resources Foley catheter is the optimal choice for pre induction cervical ripening in terms of cost effectiveness and attaining the desired results.
Pre-term cervical ripening and labor induction
European Journal of Obstetrics & Gynecology and Reproductive Biology, 2002
Objective: To evaluate retrospectively pre-term induction; with Prostaglandin (PG) E 2 -gel and i.v. oxtytocin, respectively. Methods: Fifty pre-term women with a gestational age between 28 þ 0 and 36 þ 6 and medical indications for labor induction were compared with the two next induced at term and post-term. The obstetric end points were numbers of PGE 2 -gel applications, failed inductions, instrumental delivery and heavy bleeding after partus (>1000 ml). The neonatal outcome was registered as operative delivery for fetal distress (ODFD) or Apgar score <7 at 5 0 . Results: The number of PGE 2 -gel applications did not differ. The duration of labor was shorter in the pre-term group (P ¼ 0:043). A five-fold higher risk of heavy postpartum bleeding (>1000 ml) was noticed in the post-term group compared to the pre-term. The incidence of low Apgar scores were similar in the three groups. Conclusions: Safe vaginal labor induction and delivery can be anticipated pre-term with PGE 2 -gel. #
Predicting factors on cervical ripening and response to induction in women pregnant over 37 weeks
2013
Induction of labor is conducted in special fetal or maternal conditions. Labor is induced in about 20% of women. The aim of this study was realizing the relationship between some factors including cervical ripening and also response to induction so we could predict the induction outcome better. Material and methods: The present prospective study was based on 101 pregnancy cases admitted to the labor ward in Urmia from March 2010 until December 2010. Maternal age ranged from 17 to 41 years and the gestational age between 37 to 42 weeks according to an ultrasound or reliable last menstrual period, as criteria of study inclusion. After admission, patients had a vaginal speculum for Preterm Premature Rupture of Membranes (PPROM), Abdominal ultrasonography for biometry and Amniotic Fluid Index (AFI), transperineal ultrasonography for measuring fetal head distance to maternal perineum, and vaginal ultrasonography for measuring cervical length and posterior angle of fetal head with cervix were undergone. Bishop score was assigned to another person. Labor was induced by administering either intravaginal misoprostol (25 microgram every six hours for a Bishop score lower than 7) or intravenous oxytocin (low dose regimen for a Bishop score equal to or more than 7). Results: Misoprostol was used for 75 patients and 26 patients had induction of labor with low dose oxytocin. Eighty one patients had Normal Vaginal Delivery (NVD) while 20 were delivered via Cesarean Section. For cervical ripening, Bishop Score (p<0.001), cervical length (p=0.04) and parity (p=0.06) were predicting factors. The cervical posterior angle p=0.02 had a predicting role in natural delivery. Conclusion: The cervical posterior angle was a predicting factor for natural delivery. Although cervical length, Body Mass Index (BMI), and parity were not predicting factors for natural delivery; these factors were good predictors for cervical ripening.
Australian and New Zealand Journal of Obstetrics and Gynaecology, 2016
Background: Pre-induction cervical ripening greatly influences the outcome of induction of labour (IOL). Aims: To compare the efficacy of combined Foley's catheter and vaginal misoprostol with Foley's catheter or low-dose vaginal misoprostol alone for cervical ripening. Materials and methods: Women with a singleton pregnancy admitted at term for cervical ripening and IOL based on clinical indication were randomised into three groups. Oxytocin augmentation was done in the groups as indicated. Significant tests were done using chi square, Fisher's exact and analysis of variance tests. Results: A total of 210 women were randomised into the study. Women in the combined group (Foley's catheter and vaginal misoprostol) had significantly higher postcervical ripening Bishop's score than the women in the other two groups; P = 0.001. Cervical ripening time, induction-delivery time and cervical ripening-delivery interval were significantly shorter in the combined group compared to the other two groups; P = 0.001. Also, women in the combined group required significantly lesser oxytocin augmentation than the other two groups; P = 0.001. There was no difference in Apgar scores at 1 or 5 minutes or in special baby care unit admission among the groups. There were no reported cases of uterine contractile abnormalities or rupture in this study. Conclusion: Combined Foley's catheter and vaginal misoprostol provide a shorter duration to the achievement of cervical ripening.
International Journal of Research in Medical Sciences
Background: The ripeness of the cervix is an important prerequisite to a successful labour induction. Use of extra-amniotic Foley catheter is a mechanical method of cervical ripening with proven efficacy. This study compared the difference in efficacy between 30 ml and 60 ml of water for inflation of Foley catheter balloon when used for cervical ripening during induction of labour.Methods: A single-blind randomized controlled study where 260 term pregnant women with intact membranes and unfavourable cervix were selected for induction of labour and randomized into two equal groups (30 ml- and 60 ml- groups) from October, 2019 to July 2020. Each participant had cervical ripening with the catheter bulb inflated with either 30 ml or 60 ml of sterile water (as assigned to the individual). After achieving favourable cervix (BS ≥6), oxytocin titration was commenced and the labour monitored with the outcomes well documented and statistically analysed.Results: Mean duration to favourable Bis...