INDUCTION OF LABOUR WITH FOLEY’S CATHETER VERSUS VAGINAL MISOPROSTOL AT TERM
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2019, Vol 6, Issue 11
Abstract
BACKGROUND The incidence of induction of labour is raising worldwide with a rate of 20% to 30% in developed countries. At present, each method of induction of labour has its own merits and demerits. We studied the safety and efficacy of Foley’s catheter in induction of labour at term and compared its safety and efficacy with that of vaginal misoprostol. MATERIALS AND METHODS This is a case-control study conducted on 100 pregnant women planned for induction of labour at term with a Bishop’s score of ≤6. Women were randomly divided into two groups of 50 patients in each group. In group A, labour was induced with trans cervical Foley’s catheter and in women in group B labour was induced with 25 micrograms of intravaginal misoprostol 4th hourly up to maximum of 6 doses. Induction delivery intervals and fetomaternal outcomes were noted. RESULTS In group A (Foley’s catheter group) only 50% of women delivered before 24 hours whereas 94% of group B (Misoprostol group) delivered before 24 hrs. The induction to delivery interval in group B is significantly shorter compared to group A. The rate of vaginal delivery was 76% in group A versus 82% in group B. The rate of caesarean section due to failed induction was 58.4% in group A compared to 22% in group B. There were higher rates of APGAR ≤6, Meconium stained liquor and NICU admissions in group B compared to group A. CONCLUSION Intravaginal Misoprostol is associated with shorter induction to delivery interval compared to Foley’s catheter and higher rate of vaginal delivery in case of unripe cervix. Whereas trans-cervical Foley’s catheter is associated with lower incidence of hyperstimulation and may be a reasonable alternative for patients who are at increased risk of uterine rupture during labour.
Authors and Affiliations
Venkata Ramana Kodali, Padma Leela Kotipalli, Madhuri Ampilli, Naga Lalitha Kokkiligadda, Mitra Vinda Vayilapalli, Mounica Kollabathula
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