Comparison of Foley catheter and prostaglandin E2 tablets for the induction of labor at term

Abstract

The aim of the paper was to assess success rates and associated maternal and fetal risks, to determine the different methods of induction for labor at term, compare induction with Foley catheter and induction with naturally occurring prostaglandin E2 (PGE2) tablets in women with gestational age at term. Two hundred and twelve women at term were included into the study, one group with Foley catheter, the second group with PGE2 tablets, with a maximum of two doses. The primary outcome measures were the admission-to-delivery interval and the induction-to-delivery interval. Secondary outcomes included cesarean section rate, mode of delivery, and maternal and neonatal safety outcome. Results were calculated by applying the Fisher’s exact test, c2-test, t-test and calculating the P-value using an alpha level of 0.05 for Type I errors. The mean time from admission to delivery was 13.53h in the Foley catheter group and 12.30h in the PGE2 group (P=0.090). The induction-to-delivery interval was also comparable between the groups (10.75h vs 9.37h), while the cesarean section rate did not differ significantly between them (7.61% vs 15.30%). More women in the misoprostol group had an instrumental delivery (12.38% vs 2.94%). The only significant difference in neonatal outcome was a larger number of babies born with Apgar score < 7 at 1 min in the Foley group. Maternal outcomes were not significantly different, except for a higher number of digital examinations in the Foley group. Foley catheter is equally efficacious in labor induction and demonstrates a similar fetal and maternal safety profile to PGE2.

Keywords

• Foley catheter
• Prostaglandin E2
• neonatal outcome
• induction of labor
• neonatal outcome