Is transcervical Foley catheter actually slower than prostaglandins in ripening the cervix? A randomized study

• Published in: American journal of obstetrics and gynecology Vol. 204; no. 4; pp. 338.e1 - 338.e7
• Main Authors: Cromi, Antonella, PhD, Ghezzi, Fabio, MD, Agosti, Massimo, MD, Serati, Maurizio, MD, Uccella, Stefano, MD, Arlant, Veronica, MD, Bolis, Pierfrancesco, MD
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.04.2011; Elsevier
• Subjects: Administration, Intravaginal; Adult; Biological and medical sciences; Catheterization; Catheters; Cervical Ripening; Delivery, Obstetric; Dinoprostone - therapeutic use; Female; Foley catheter; Gynecology. Andrology. Obstetrics; Humans; Labor, Induced; mechanical method; Medical sciences; Obstetrics and Gynecology; Oxytocics - therapeutic use; Pregnancy; prostaglandin; ripening time; Time Factors; cervical ripening; prostaglandin; Foley catheter; mechanical method; ripening time; Ripening; Randomization; Prostaglandin; Gynecology; Catheter; Clinical trial; Transcervical route; Uterine cervix; Obstetrics
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2010.11.029

Objective The purpose of this study was to determine whether the maximum time for cervical ripening (from 24-12 hours) would influence the efficacy of a transcervical Foley catheter and to compare efficacy to that of a prostaglandin E2 vaginal insert. Study Design Three hundred ninety-seven women were assigned randomly to (1) Foley catheter left in place for a maximum of 24 hours, (2) Foley catheter left in place for a maximum of 12 hours, or (3) prostaglandin E2 controlled-release vaginal insert. Primary outcome was vaginal delivery within 24 hours. Results There were no differences in vaginal delivery rates. The proportion of women who achieved vaginal delivery in 24 hours was lower in the 24-hour Foley catheter group than in the other 2 groups (24-hour Foley catheter, 21.0%; 12-hour Foley catheter, 59.8%; vaginal prostaglandin E2 , 48.5%; P < .0001). Conclusion Cutting the ripening time with a Foley catheter by one-half increases the proportion of women who deliver vaginally within 24 hours and yields efficacy similar to that of prostaglandin E2 vaginal insert.