Prostaglandin E2 versus foley catheter balloon for induction of labor at term : a randomized controlled study

Abstract EN

Objective : The aim of this study is to evaluate the efficacy, safety and side effects of intracervical Foley catheter balloon in comparison with intra vaginal prostaglandin pessaries in preinduction cervical ripening at term.

Methods : This randomized prospective study was conducted in the maternity department at King Hussein Medical Centre and Prince Ali Bin Al-Hussein Hospital between July 2009 and July 2010.

Four hundred and fourteen women who required induction of labor, with a Bishop score of less than or equal to 5 and met the inclusion criteria, were randomized into two groups : 204 women received prostaglandin E2 vaginal tablets (group I) and 210 women had an intracervical Foley catheter inserted, and the balloon inflated with 60 ml N / Saline (Group II).

The outcome measures were: mode of delivery, time interval between induction to delivery and maternal and neonatal adverse reactions.

Results : Age, parity and indications for induction of labor, were similar in both groups.

In Group I, 63 % achieved normal vaginal delivery compared to 61 % in Group II (p = 0.8).

Cesarean section rate was 34 % in both groups.

The rest had instrumental delivery.

The time interval between induction to delivery was longer in the Foley catheter group than PGE2, but not statistically significant (mean 22.6 h vs.

21.4 h ; P = 0.3101).

The rate of oxytocin administration was more in Foley catheter group than Prostaglandin E2 (78.6 % vs.65.7 % ; P = 0.018).

Uterine hyper stimulation was more in PGE2 group than Foley catheter 6 (3 %) vs.1 (0.5 %) ; P = 0.0013).

The Apgar scores, neonatal birth weight and admission to neonatal intensive care unit showed no difference between the two groups.

Conclusion : PGE2 vaginal tablets and Foley catheter are comparable in efficacy for induction of labor in women at term.

However, Foley catheter has the advantage of being safe, simple, reversible and associated with fewer side effects.