Comparison of the efficacy, safety, acceptability and fetomaternal outcomes of combination of mifepristone and foley’s catheter with foley’s catheter alone in induction of labour in term pregnancies with previous lower segment caesarean section

Authors

  • Nancy Thind Department of Obstetrics and Gynecology, IGMC, Shimla, Himachal Pradesh, India
  • Pranav Sood Department of Obstetrics and Gynecology, IGMC, Shimla, Himachal Pradesh, India
  • Rajeev Sood Department of Obstetrics and Gynecology, IGMC, Shimla, Himachal Pradesh, India
  • Geetika Gupta Syal Department of Obstetrics and Gynecology, IGMC, Shimla, Himachal Pradesh, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20204310

Keywords:

Bishop score, Foley’s catheter, Induction of labor, Mifepristone, Previous LSCS

Abstract

Background: Objective of the study was to compare the efficacy, safety, acceptability, fetomaternal outcomes of combination of mifepristone and Foley’s catheter with Foley’s catheter alone in induction of labor in term pregnancies with previous Lower segment caesarean section (LSCS).

Methods: This was a prospective study of 36 women induced with mifepristone and foley’s catheter and 36 women induced with foley’s catheter alone at 37 weeks to 41+6 weeks with previous LSCS.

Results: Mean bishop score on admission in combined group (2.44) was comparable with that of foley’s alone group (2.91, p=0.888). Mean Bishop score (BS) after foley’s expulsion in group A and group B was 7.46 and 6.33 respectively, which was statistically significant (p<0.001). In group A 69.5% of women delivered vaginally compared to 52.2% in group B which was comparable (p=0.230). Mean induction to delivery interval was significantly short in combination group (15.5±1.3 hours versus 20.8±1.07 hours, p=0.003). 50% women in group A required oxytocin for induction/ augmentation of labour as compared to 77.8% in group B (p=0.02). Failed induction was statistically higher in group B (p<0.05). No difference was found with regards scar dehiscence, scar rupture, Postpartum hemorrhage (PPH), wound infection, puerperal pyrexia, Meconium stained liquor (MSL), fetal distress, mean birth weight, 1 and 5 minutes Appearance, pulse, grimace, activity, and respiration (APGAR) score, neonatal outcome, hospital stay.

Conclusions: Priming with mifepristone before insertion of foley’s catheter results in significant change in BS signifying that combination promotes early cervical ripening as compared to foley’s catheter alone. Mifepristone plays significant role in cervical ripening, reduces induction to delivery interval, oxytocin requirement and failed induction.

References

Flamm BL. Once a cesarean, always a controversy. Obstet Gynecol. 1997;90(2):312-5.

Cypher RL. Cesarean Birth: A Journey in Historical Trends. J Perinat Neonatal Nurs. 2016;30(3):259-64.

Niino Y. The increasing cesarean rate globally and what we can do about it. Biosci Trends. 2011;5(4):139-50.

Arulkumaran S. Caesarean section rates are increasing worldwide. Preface. Best Pract Res Clin Obstet Gynaecol. 2013;27(2):151-2.

Sharma C, Soni A, Soni PK, Verma S, Verma A, Gupta A. A Retrospective Case-Control Study Evaluating the Role of Mifepristone for Induction of Labor in Women with Previous Cesarean Section. J Obstet Gynaecol. 2016;66(1):30-7.

Meetei LT, Suri V, Aggarwal N. Induction of labor in patients with previous cesarean section with unfavorable cervix. J Med Soc. 2014;28(1):29-33.

Cheuk QKY, Lo TK, Lee CP, Yeung APC. Double balloon catheter for induction of labour in Chinese women with previous caesarean section: one-year experience and literature review. Hong Kong Med J Xianggang Yi Xue Za Zhi. 2015;21(3):243-50.

Madaan M, Agrawal S, Nigam A, Aggarwal R, Trivedi SS. Trial of labor after previous caesarean section: the predictive factors affecting outcome. J Obstet Gynecol. 2011;31:224-8.

Landon MB, Leindecker S, Spong CY, Hauth JC, Bloom S. The MFMU Cesarean Registry: Factors affecting the success of trial of labor after previous cesarean delivery. Am J Obstet Gynecol. 2005;193:1016-23.

FOGSI-ICOG 2018. Induction of Labor: Good Clinical Practice Recommendations. Last accessed on 1st December 2018.

Athawale R, Acharya N, Samal S, Hariharan C. Effect of mifepristone in cervical ripening for induction of labour. Int J Reprod Contracept Obstet Gynecol. 2016;2(1):35-8.

Sharma C, Soni A, Gupta A, Verma A, Verma S. Mifepristone vs balloon catheter for labor induction in previous cesarean: a randomized controlled trial. Arch Gynecol Obstet. 2017;297(1):77-83.

HK R, DS. Case series of Foley’s induction in patients with previous caesarean. Int J Reprod Contracept Obstet Gynecol. 2017;6(4):1635.

Rezk M, Sanad Z, Dawood R, Masood A, Emarh M, Halaby AA. Intracervical Foley Catheter Versus Vaginal Isosorbid Mononitrate for Induction of Labor in Women With Previous One Cesarean Section. J Clin Gynecol Obstet. 2014;3(2):55-61.

Acharya R, Chaudhari P, Choudhary A, Sharma A, Jain S. Mifepristone as cervical ripening agent for Labour induction in women with Previous one Caesarean Section. Int J Med Res Rev. 2016;4(4):624-9.

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Published

2020-09-25

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Original Research Articles