Comparative Study of Intra-Cervical Foley’s Catheter and Intra- Cervical PGE2 Gel For Pre-Induction Ripening of Cervix

Introduction: Numerous techniques have been used to ripen the unfavourable cervix to achieve the changes necessary for labour. Prostaglandins are the most commonly used pharmacological agents for ripening of cervix and PGE2 gel is the agent of choice for this purpose. Materials and methods: In present study 100 singleton pregnant women who were counselled & in whom cervical ripening and labour induction was indicated were studied. 50 women received Foley’s catheter intra-cervically and bulb inflated with 30ml of normal saline & the remaining 50 women received 0.5mg of Dinoprostone gel. Results: Majority of patients in Foley’s group had bishops score 2 in 48% & 50% in dinoprostone forming a major group. The mean induction delivery interval was 13.9 hrs & 11.5 hrs in primigravidae & multigravidae respectively, giving a total mean of 12.5 hrs. 82% had vaginal delivery & 18% had caesarean delivery in Foley’s group as compared to dinoprostone where vaginal delivery was 68% & caesarean delivery 36%. The rate of failed induction was 22% in Foley’s group, the major indication being fetal distress & secondary arrest of dilatation. In dinoprostone group 36% cases were failed induction, major cause was secondary arrest of dilatation. There was 10% incidence of side effects of dinoprostone of which 2% hyper stimulation, 2% fever, 2% vomiting, 2% diarrhoea, 2% PPH. In Foley’s group the incidence of side effect is 2% vomiting. There was 4% incidence of NICU admission in Foley’s group & 12% in dinoprostone group. Conclusion: Study suggest that Foley’s catheter & PGE2 gel are showing almost equal results, but Foley’s catheter is a safer, easier, cheaper, effective method of pre-induction cervical ripening and can be used in PGE2 contraindicated cases.