Role of intracervical foley's catheter as pre-induction cervical ripening agent in reducing rate of primary caesarean section

Abstract

Induction of labour may be required for various maternal or foetal reasons at times in the presence of poor Bishop’s scoring. Cervical ripening is beneficial in these situations. A randomised comparative analysis was carried out using intracervical Foleys catheter instillation followed by a single dose of dinoprostone gel if required in one group and only dinoprostone gel for ripening in other group. Maternal and neonatal complications, mode of delivery and induction-delivery interval were assessed. We found a higher vaginal delivery rate of 82% in the first group in comparison to 64% in the other group. The difference was statistically significant (p=0.0426). Though a longer induction-delivery interval was observed in the first group, the maternal and foetal outcomes were similar. Intracervical Foley’s catheter instillation when used for cervical ripening in unfavourable cervices, either alone or sequentially with dinoprostone gel can significantly reduce the Primary Caesarean section rate without compromising maternal and neonatal safety.