Comparative Study of Intracervical Foleys Catheter Instillation vs PGE2 Gel for Induction of Labour

Background: Cervical ripening, before induction of labour, is needed to increase the success of labour induction, to reduce complications and to diminish the rate of cesarean section and duration of labour. Pharmacological preparations are in widespread use for cervical ripening but are not free from side-effects and complications. Mechanical methods, i.e. the use of Foley’s catheter balloon, though effective have not gained much popularity because of the fear of infection. Therefore, this study has been conducted to prove the efficacy and safety of extra amniotic Foley’s catheter balloon and to compare it with intra-cervical prostaglandin E2 (PGE2) gel. The objective of this study was to the success of induction of labor depends on the cervical status at the time of induction. For effective cervical ripening both Foley's catheter and PGE2 gel are used. The aim of this study was to compare the efficacy of intra cervical Foley's catheter and intra cervical PGE2 gel in cervical ripening for the successful induction of labor. Methods: A randomized, comparative study was conducted in the Department of Obstetrics and Gynaecology, Nalanda Medical College and Hospital, Patna, during a period of one year from January 2016 to January 2017. 100 patients at term with a Bishop's score ≤3 with various indications for induction were randomly allocated to receive (50 pts) intra-cervical Foley's catheter or PGE2 gel (50pts). After 6 hours post induction, Bishop's score was noted, labou3,4 was augmented if required. Statistical analysis was done using Chi square test and t test. Results: The groups were comparable with respect to maternal age, gestation age, indication of induction and initial Bishop's score. Both the groups showed significant change in the Bishop's score, 5.10±1.55 and 5.14±1.60 for Foley', s catheter and PGE2 gel, respectively, p value < 0.001. However, there was no significant difference between the two groups. No difference in either the side effects or the caesarean section rates were observed. The induction to delivery interval was 16.01+5.50 hours in the foley’s group (F) and and 16.8 + 3.8 hours in PGE2 group (P). APGAR scores and NICU admissions showed no difference between the two groups. Conclusion: The study shows both Intracervicalfoleyscathter and PGE2 gel are equally effective for cervical ripening.