Catarina Policiano1, Mariana Pimenta1, Diana Martins2, Nuno Clode1. 1. Department of Obstetrics and Gynecology. Hospital Universitário de Santa Maria. Academic Medical Center of Lisbon. Lisbon. Portugal. 2. Department of Obstetrics and Gynecology. Hospital Beatriz Ângelo. Loures. Portugal.
Abstract
INTRODUCTION: Foley catheter promotes cervix priming by a direct mechanical effect of distension. MATERIAL AND METHODS: A prospective observational study was conducted at a tertiary hospital, including all cases of induction of labor with Foley catheter between September 1, 2013 and November 30, 2015. Women were eligible if they had a singleton pregnancy with a Bishop score < 6 and a gestational age ≥ 41 weeks or a medical indication for induction of labor. The primary outcome was the Bishop score variation (difference between Bishop score before and after insertion of Foley catheter). Mode of delivery, induction-to-delivery time, uterine tachysystole with fetal decelerations, peripartum fever ≥ 38º C, maternal pain and mortality were also analyzed. RESULTS: Within 201 inductions with Foley catheter, average increase in Bishop score after catheter placement was three (1 - 7), with only 5% (11/201) of unmodified cervix after catheter removal/extrusion. Vaginal delivery rate was 71% (142/201) and in women with a previous cesarean section (n = 40) was 37% (15/40). Average induction-to-delivery time was 38 hours (4 - 120). Uterine infection rate was 3% (6/201). There was only one case of significant vaginal bleeding which required immediate catheter removal. There has been no significative maternal or neonatal morbidity. DISCUSSION/ CONCLUSION: Foley catheter is a safe and effective method of cervical priming for women with an unfavorable cervix, even in the case of a previous cesarean delivery.
INTRODUCTION: Foley catheter promotes cervix priming by a direct mechanical effect of distension. MATERIAL AND METHODS: A prospective observational study was conducted at a tertiary hospital, including all cases of induction of labor with Foley catheter between September 1, 2013 and November 30, 2015. Women were eligible if they had a singleton pregnancy with a Bishop score < 6 and a gestational age ≥ 41 weeks or a medical indication for induction of labor. The primary outcome was the Bishop score variation (difference between Bishop score before and after insertion of Foley catheter). Mode of delivery, induction-to-delivery time, uterine tachysystole with fetal decelerations, peripartum fever ≥ 38º C, maternal pain and mortality were also analyzed. RESULTS: Within 201 inductions with Foley catheter, average increase in Bishop score after catheter placement was three (1 - 7), with only 5% (11/201) of unmodified cervix after catheter removal/extrusion. Vaginal delivery rate was 71% (142/201) and in women with a previous cesarean section (n = 40) was 37% (15/40). Average induction-to-delivery time was 38 hours (4 - 120). Uterine infection rate was 3% (6/201). There was only one case of significant vaginal bleeding which required immediate catheter removal. There has been no significative maternal or neonatal morbidity. DISCUSSION/ CONCLUSION: Foley catheter is a safe and effective method of cervical priming for women with an unfavorable cervix, even in the case of a previous cesarean delivery.