Comparative Study of Efficacy of Intracervical Foley Catheter with Intravaginal Misoprostol in Induction of Labour in Primigravida with Term Pregnancy

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Dr. Mini Mohan
Dr. Madhusree .

Abstract

Background: Worldwide induction of labour is one of the most common procedures in obstetrics. Different interventions are available for labour induction. These intervention include mechanical methods such as transcervical insertion of Foley's catheter and administration of medicinal products such as misoprostol, dinoprostone and oxytocin.



Objective: To compare the efficacy of Foley's catheter placed extraamniotically with that of misoprostol intravaginally for induction of labour in primigravida with gestational age more than 37 weeks.



Materials & Methods: The present prospective randomized comparative study was carried out in the Department of Obstetrics and Gynaecology at Durgabai Deshmukh Hospital and Research Centre, Hyderabad from June, 2016 to June, 2018. The study included 250 primigravida with indication for labour and gestational age >37 weeks. The subjects were divided into two groups: 125 women induced with intracervical Foley catheter (Group A) and 125 women induced with vaginal misoprostol (Group B). The endpoints of the study were - improvement of Bishop's score, induction delivery interval, mode of delivery, and the neonatal outcome.



Results: The mean Bishop's score after 12 hours in Foley catheter group was 8.08 and 8 in misoprostol group (p value
0.65). The induction delivery interval was 17.4 hours in Foley catheter group and 14 hours in misoprostol group (p < 0.05). The need of oxytocin augmentation was required in 78.4% women in Foley catheter group and 46.4% women in misoprostol group (p < 0.05). The rate of vaginal delivery was 60.8 % in Foley catheter group and 81.6 % in misoprostol group. There was no tachysystole, no hyperstimulation, no pyrexia in Foley catheter group while in vaginal misoprostol group the rate was 8.8 %, 11.2%, 4.8% respectively. There was no difference between the two groups with respect to neonatal outcome.



Conclusion: The present study concluded that Foley's catheter was less efficacious in induction of labour compared to intravaginal misoprostol in terms of induction delivery time, need for labour augmentation and caesarean section. Complications such as tachysystole, hyperstimulation and pyrexia were more with misoprostol. However, more studies with larger samples can justify these results.



Keywords: Foley catheter; Misoprostol; Caesarean section; Oxytocin, Dinoprostone

Published May 22, 2020

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