Preparation for Induction of Labour of the Unfavourable Cervix with Foley Catheter Compared with Vaginal Prostaglandin

Publisher Website
Google Scholar
Abstract
EDITORIAL COMMENT: It is salutary to note that many workers now advocate mechanical methods of cervical dilatation condemned in the past for very good reasons (maternal infection, cervical trauma). It is also noteworthy that this paper reports impressive results of Foley catheter with traction (spontaneous vaginal delivery 66%, Caesarean section rate 22%) in patients with an unfavourable cervix who required induction of labour (see Arulkumanan et al Aust. NZJ Obstet. Gynaecal. 1985; 25: 190–193). Summary: Ripening of the unfavourable cervix prior to induction of labour using traction on a Foley catheter (32 patients) was compared with 40 mg of prostaglandin F2α in Tylose gel applied to the external cervical os and held in place for 12 hours with a vaginal diaphragm (25 patients). Each patient in the above groups had a modified Bishop score of 0–3 and was randomly allocated to one or other group. Comparison was made with a further 25 patients in whom the cervical score was 4–6. Timing of amniotomy and commencement of Syntocinon infusion were equivalent for all patients. Prostaglandins conferred no advantage over Foley catheter in terms of am‐niotomy‐delivery interval, operative delivery rate, and condition of the baby one minute after birth. The disadvantages of prostaglandins for cervical ripening are a longer preparation‐delivery interval, and cost ($77 versus $4.75 for the Foley catheter). Currently, prostaglandins are not officially approved for use in Australia for induction of labour. It is suggested, therefore, that the Foley catheter is preferable for ripening the unfavourable cervix as a prelude to amniotomy.

This publication has 7 references indexed in Scilit: