DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20205461

Comparative study between transcervical extra-amniotic Foley’s bulb and prostaglandin E2 gel for pre-induction cervical ripening

Prajakta Goswami, Kapil Annaldewar, Deepali Giri, Sachin Giri

Abstract


Background: Induction of labor is an artificial initiation of uterine activity before the spontaneous onset of labor with the aim of achieving vaginal delivery. Various pharmacological and non-pharmacological methods have been studied for the purpose.

Methods: This randomized prospective study conducted in the Department of Obstetrics and Gynaecology at the Seth V. C. Gandhi & M. A. Vora Municipal General Hospital (Rajawadi Hospital), Mumbai from June 2019 to April 2020. It included pregnant patients admitted to the labor ward for induction of labor. A total 200 women were recruited and randomly allocated to the two study groups fulfilling the following selection criteria. Of these, 100 women were included in Foley's catheter group (group A) and 100 in (group B) prostaglandin E2 (PGE2) group.  

Results: The subjects included mainly were of 24-28 years age group. The period of gestation was 37-42 weeks in majority of the women in both the groups. Maximum numbers of women in both groups were primigravidae, being 66% in group A and 70% in group B. Foley catheter proved to be a highly effective pre-induction ripening agent for unfavorable cervix, compared to PGE2 gel, as evident by the mean Bishop score at 12 hours (p<0.05) and by the difference in change of Bishop score over 12 hours (p<0.05) in both groups A and B. Women in both the groups had a high rate of normal vaginal delivery, rate being significantly more in Foley’s group.

Conclusions: This study concludes that extra-amniotic Foley’s catheter balloon is an effective, safe, simple, low cost, reversible, non-pharmacological mechanical method of pre-induction cervical ripening.


Keywords


Prostaglandin E2, Foley’s catheter, Cervical ripening

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References


Farrington PF, Ward K. Normal labor, Delivery, and Puerperium. In: Danforth DN, De Saia PJ, Hammond CB, Spellacy WN, Smith J, editors. Danforth's Obstetrics and Gynecology. 8th ed, Lippincott Williams and Wilkins. 1999:91-109.

Hadi H. Cervical ripening and labor induction: clinical guidelines. Clin Obstet Gynecol. 2000 Sep; 43(3): 524-536. catheter with PGF2alpha in mid-trimester pregnancy

Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Gilstrapiii LC, Wenstrom KD. Induction of labor. In: Williams obstetrics. 22nd ed. New York: McGgraw-Hill; 2005:535-45.

Embrey MP, Anselmo JF. The effects of intravenous oxytocin on uterine contractility. J Obstet Gynaecol Br Commonw. 1962;69:910-7.

Turnbull AC, Anderson AB. Introduction of labor. J Obstet Gynaecol Br Commonw, 1968;75:32-41.

Bishop EH. Pelvic scoring for elective induction. Obstet Gynecol. 1964;24:266-8.

Anderson MM. The state of the cervix and surgical induction of labour. J Obstet Gynaecol Br Commonwealth. 1965;72:711.

Cocks DP. Significance of initial condition of cervix uteri to subsequent course of labour. Br Med J. 1955;1:327-8.

Keettel WC. Hazards of elective induction of labor. Amer J Obstet Gynaec. 75:3:1959.

Niswander KR, Patterson RJ. Hazards of elective induction of labor. Obstet Gynec. 1963;22:2.

Rouse D, Owen J, Hauth JC. Criteria for failed, labor induction: Prospective evaluation of a standardized protocol. Am J Obstet Gynecol. 2000;182:S132.

Turnbull AC, Anderson AM. Induction of labor. II. Intravenous oxytocin infusion. J Obstet Gynaecol Common. 1968;75:24-31.

Misra R, editor. Induced Labor. In: Ion donald’s practicle obstetric problems. 6th ed. New Delhi: BI Publications Pvt Ltd. 2007:488-505.

Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Gilstrapiii LC, Wenstrom KD et al. Williams obstetrics. 22nd ed. New York: McGgraw-Hill; 2005:837.

Mahmood TA. A prospective comparative study on the use of prostaglandin E2 gel (2mg) and prostaglandin E2 tablet (3mg) for the induction of labor in primigravid women with unfavorable cervices. Eur J Obstet Gynaecol Reprod Biol. 1989;33:169-75.

Zanani A, Guidini A, Norchi S, Beretta E, Cortinovis I, Bottino S. Preinduction cervical ripening with prostaglandin E2 gel: Intracervical versus intravaginal route. Obstet Gynaecol. 1990;76:681.

Chatterjee MS, Ramchandran K, Ferlita J, Mitrik L. Prostaglandin E2 vaginal gel for cervical ripening. Eur J Obstet Gynaecol Reprod Biol. 1991;38:197-202.

Sawai SK, Williams MC, O’Brien W. Sequential outpatient application of intravaginal prostaglandin E2 gel in the management of postdated pregnancies. Obstet Gynaecol. 1991;78:19-22.

Lyndrup J, Nickelsen C, Guldbeak E, weber T. Induction of labor by prostaglandin E2: Intracervical gel or vaginal pessaries? Eur J Obstet Gynaecol Reprod Biol. 1991;42:101-9.

Trootwijk AL, van Veen JBC, Doesburg WH. Preinduction intracervical application of a highly viscous prostaglandin E2 gel in pregnant women with an unripe cervix: A double blind placebo control trial. Eur J Obstet Gynaecol Reprod Biol 1992;43:105-11.

Ray DA, Garite TJ. Prostaglandin E2 for induction of labor in patients with premature rupture of membranes at term. Am J Obstet Gynaecol. 1992;166:836-43.

Sherman DJ, Frenkel E, Tovbin J, Arieli S, Caspi E, Bukovsky I. Ripening of the unfavorable cervix with extraamniotic catheter balloon: clinical experience and review. Obstetrical Gynecol Surv. 1996;51(10):621-7.

Huang W, Chung J, Rumney P. A prospective, randomized controlled trial comparing misoprostol, Foley catheter, and combination misoprostol-Foley for labor induction. Am J Obstet Gynecol. 2002;187:S57.

Trofatter KF. Cervical ripening. Clin Obstet Gynecol. 1992;35:476-84.

Barnes J. Induction of labor. Proc Roy Soc Med. 1965;58:304.

Embry MP, Mollison BG. The unfavorable cervix and induction of labor using a cervical balloon. J Obstet Gynaecol. 1967;74:44-8.

Perry KG Jr, Larmon JE, May WL, Robinette LG, Martin RW. Cervical ripening: a randomized comparison between misoprost and an intracervical balloon catheter combined with intra vaginal dinoprostone. Am J Obstet Gynecol. 1998;178(6):1333-40.

Ezimokhai M, Nwabinelli JH, the use of Foley catheter in ripening the unfavorable cervix prior to induction of labour. Br J Obstet Gynaecol. 1980;87:281-86.

St Onge RD, Connors GT. Preinduction cervical ripening: A comparison of intracervical prostaglandin E2 gel versus Foley catheter. Am J Obstet Gynecol. 1995;172:687-90.

Rouben D, Arius F randomized trial of extra amniotic saline infusion plus intracervical Foley catheter balloon versus prostaglandin E2 vaginal gel for ripening the cervix and inducing labour in patients with unfavorable cervices. Obstet Gynecol. 1993;82:290-4.

Sherman MD, Eugenia Frenkel, Mordechai, Pansky MD. Balloon cervical Ripening with Extra-Amniotic Infusion of Saline or prostaglandin E2: A double Blind, Randomized Controlled Study. Obstet Gynecol. 2001;97:375-80.

Schreyer PE, Sherman DJ, Ariely SH, Herman AR, Caspi EL. Ripening the highly unfavorable cervix with extra-amniotic saline instillation or vaginal prostaglandin E2 application. Obstet Gynecol. 1989;73(6):938-42.

Cromi A, Ghezzi F, Tomera S, Uccella S, Lischetti B, Bolis PF. Cervical ripening with the Foley cathter. Int J Gynaecol Obstet. 2007;97(2):105-9.

Sciscione AC, McCullough H, Manley JS, Shlossman PA, Pollock M, Colmorgen GH. Am J Obstet Gynecol.1999;180(1):55-60.

Dalui R, Suri V, Ray P, Gupta I. Comparison of extra amniotic Foley’s catheter and intracervical prostaglandin E gel for pre induction cervical ripening. Acta Obstet Gynecol Scand. 2005;84(4):362-7.

Ferdous J, Khanum N, Begum M, Akhtar S. Cervical Ripening: Comparative study between intracervical balooning by foley’s catheter and intravaginal misoprostol tablet. J Bangladesh Coll Phys Surg. 2009;27:5-12.

Theiry M. Pre induction cervical ripening. Obstet Gynecol Annu 1983;12:103.

Ulmsten U, Wingerup L, Frage P, Ekman G, Wiqvist M. Intracervical application of prostaglandin gel for induction of term labor. Obstet Gynecol. 1983;59:336-9.

Huszar G, Naftolin F. The myometrium and uterine cervix in normal and preterm labor. N Engl J Med. 1984;311:571-5.

Lieberman JR, Piura B, Chaim W. The cervical balloon method for induction of labour. Acta Obstet Gynecol Scand. 1977;56:499-503.

Bernstein P. Prostaglandin E2 gel for cervical ripening and labour induction; A multicentered placebo-controlled trial. Can Med Assoc J. 1991;145:1249-54.