Comparative Study of Intra-cervical Foley's Catheter and PGE(2) Gel for Pre-induction Ripening (Cervical)

Aim The success of induction of labor depends on the cervical status at the time of induction. Objective For effective cervical ripening both Foley's catheter and PGE(2) gel are used. The aim of this study was to compare the efficacy of intra cervical Foley's catheter and intra cervical PGE(2) gel in cervical ripening for the successful induction of labor. Study Design A randomized, prospective study was conducted in the Dept of OBGY, GMCH, Aurangabad from July 2005-January 2008. 400 patients at term with a Bishop's score <= 3 with various indications for induction were randomly allocated to receive (200 pts) intra-cervical Foley's catheter or PGE(2) gel (200 pts). After 6 h post induction, Bishop's score was noted labor was augmented if required. Statistical analysis was done using Chi square test and t test. Result The groups were comparable with respect to maternal age, gestation age, indication of induction and initial Bishop's score. Both the groups showed significant change in the Bishop's score, 5.56 +/- 1.89 and 5.49 +/- 1.82 for Foley's catheter and PGE2 gel, respectively, P < 0.001; However there was no significant difference between the two groups. There was no significant difference in the side effects. Twenty eight cesarean sections (14%) were performed in Group A and 37 (18.5%) were performed in Group B (not significant). The induction to delivery interval was 15.32 +/- 5.24 h in Group A and 14.2 +/- 5.14 h in Group B (P = 0.291). Apgar scores, birth weights and NICU admissions showed no difference between the two groups. Conclusion This study shows that both Foley's Catheter and PGE(2) gel are equally effective in pre induction cervical ripening.