A randomized controlled trial of foley catheter, extra-amniotic saline infusion and prostaglandin e2 suppository for labor induction.
AbstractObjective: The aim of this study is to further compare the efficacy of PGE2 suppository, the intracervical foley catheter and extra-amniotic saline infusion in nulliparous women referred for labor induction.Materials and methods: Totally 368 nulliparous women with a Bishop score ≤ 4 with singleton gestation, vertex presentation and intact membrane referred for labor induction were randomly assigned to 3 groups; Foley catheter alone, Extra-amniotic saline infusion (EASI) and PGE2 suppository. All women received concurrent dilute oxytocine infusion. The change in the Bishop Score, labor progress, various labor endpoints and outcomes of labor were assessed.Results: From 363 women studied after exclusion of 5, 119 were assigned to EASI, 121 to Foley and 118 to PGE2. Patients' demographics did not differ significantly between three groups nor did indication for induction (P = 0.0001). The EASI group had a significant improvement in Bishop Score 6 hours after induction. The mean time to active phase was 357±135min for EASI,457±178 for Foley and 609±238 min for PGE2 group respectively (P < 0.05).rate of spontaneous rupture of membranes was higher in the EASI group (P = 0.0001) and the mean time from the start of induction up to spontaneous rupture of membranes in the EASI group was shorter than other group(P < 0.05). The mean time to vaginal delivery was 14.8±6.1 in EASI group,11.4±4.8 in Foley and 18.9±6.4 in PGE2 group(P < 0.05).there were no differences in Apgar scores, mean neonatal birth weight and neonatal morbidity.Conclusion: Our study showed that pre-induction cervical ripening by EASI with concurrent oxytocin is better than Foley and PGE2 in Bishop score and various labor end point and outcomes.
Joan Crane St, John’s NF, Line L , Gregory J R. INDUCTION OF LABOUR AT TERM. J Obstet Gynaecol Can 2001;23:717-28.
Alec S McEwan. Induction of labour Obstetrics. Gynaecology & Reproductive Medicine2008;18: 1-6.
Vellekoop J, Vrouenraets FP, van der Steeg JW, Mol BW, Roumen FJ. Indications and results of labour induction in nulliparous women: An interview among obstetricians, residents and clinical midwives. Eur J Obstet Gynecol Reprod Biol. 2009;146:156-9.
Nicole W. Karjane, Ellen L. Brock, Scott W. Walsh. Induction of Labor Using a Foley Balloon, With and Without Extra-Amniotic Saline Infusion. Obstet Gynecol 2006;107:234–9.
Ghanaei Mm, Sharami H, Asgari A. Labor induction in nulliparous women: a randomized controlled trial of foley catheter with extra-amniotic saline infusion. J Turkish-German Gynecol Assoc 2009; 10: 71-5.
Niromanesh S, Mosavi-Jarrahi A, Samkhaniani F. Intracervical Foley catheter balloon vs.pr ostaglandin in preinduction cervical ripening. International Journal of Gynecology and Obstetrics 2003;81: 23–7.
D Rouben, F Arias. A randomiaed trial of extra-amniotic saline infusion plus intracervical foley catheter ballon versus prostaglandin E2 vaginal gel for ripening the cervix and inducing labor in patient with unfavorable cervixes. Obstet Gynecol, 1993; 82:290-4.
Vengalil SR, Guinn DA, Olabi NF, Burd LI, Owen J. A randomized trial of misoprostol and extra-amniotic saline infusion for cervical ripening and labor induction. Obstet Gynecol, 1998; 91: 774-9.
Barrilleaux PS, Bofill JA, Terrone DA, Magann EF, May WL, Morrison JC. Cervical ripening and induction of labor with misoprostol, dinoprostone gel, and a Foley catheter: A randomized trial of 3 techniques. Am J Obstet Gynecol 2002;186: 1124–9.
Culver J, Strauss RA, Brody S, Dorman K, Timlin S, McMahon MJ. A randomized trial comparing vaginal misoprostol versus Foley catheter with concurrent oxytocin for labor induction in nulliparous women. Am J Perinatol 2004;21:139–46.
Guinn DA, Goepfert AR, Christine M, Owen J, Hauth JC. Extra-amniotic saline, laminaria, or prostaglandin E(2) gel for labor induction with unfavorable cervix: a randomized controlled trial. Obstet Gynecol 2000;96:106–12.
Mullin PM, House M, Paul RH, Wing DA. A comparison of vaginally administered misoprostol with extra-amniotic saline solution infusion for cervical ripening and labor induction. Am J Obstet Gynecol 2002;187:847–52.
Charanchakul B, Herabutya Y.Randomized comparison of glyceryl trinitrate and prostaglandin E2 for cervical ripening at term. Obstet Gynecol 2000;96:549-53.
Herabutya YO, Prasertsawat P, Pokpirom J. A comparison of intravaginal misoprostol and intracervical prostaglandin E2 gel for ripening of unfavourable cervix and labor induction. J Obstet Gynecol Res 1997; 23: 369-74.
Bugalho A, Bique C, Machungo F, Faúndes A. Low-dose vaginal misoprostol for induction of labor with a live fetus. Int J Gynaecol Obstet 1995; 49: 149-55.
Wing DA, Rahall A, Jones MM, Goodwin TM, Paul RH. Misoprostol: an effective agent for cervical ripening and labor induction. Am J Obstet Gynecol 1995; 172: 1811-6.
Rayburn WF. Preinduction cervical ripening: basis and methods of current practice. Obstet Gynecol Surv 2002; 57: 683-692.
Zafarghandi A.Sh. , Zafarghandi N , Baghaii N. Foley catheter cervical ripening with extraamniotic infusion of saline or corticosteroids: a double-blind, randomized controlled study. Acta Medica Iranica2004; 4: 338-42.
St Onge RD, Connors GT. Preinduction cervical ripening: a comparison of intracervical prostaglandin E gel versus the Foley catheter. Am J Obstet Gynecol 1995;172:687–90.
Sciscione AC, McCullough H, Manley JS, Shlossman PA, Pollock M, Colomorgen GH. A prospective randomized comparison of Foley catheter insertion versus intracervical prostaglandin E2 gel for preinduction cervical ripening. Am J Obstet Gynecol 1999;180:55–60.
Orhue AA. Induction of labour at term in primigravidae with low Bishop's score: a comparison of three methods. Eur J Obstet Gynecol Reprod Biol 1995;58:119–25.
Buccellato CA, Stika CS, Frederiksen MC. A randomized trial of misoprostol versus extra amniotic sodium chloride infusion with oxytocin for induction of labor. Am J Obstet Gynecol 2000; 182: 1039-44.
Thomas IL, Chenoweth JN, Tronc GN, Johnson IR. Preparation for induction of labor of the unfavorable cervix with Foley catheter compared with vaginal prostaglandin. Aust NZ J Obstet Gynaecol 1986;26:30 –5.
Perry KG, Larmon JE, May WL, Robinette LG, Martin RW.Cervical ripening: a randomized comparison between intravaginal misoprostol and an intracervical balloon catheter combined with intravaginal dinoprostone. Am J Obstet Gynecol 1998;178: 1333 –40.
Atad J, Bornstien J, Calderon I, Petrikovsy BM, SorokinY, Aboronovici H. Non pharmaceutical ripening of the labor by a novel double balloon device. Obstet Gynecol 1991;77:146 –51.
Bartha JL, Comino-Delgado R, Garcia-Benasach F, and et al. Oral misoprostol and intracervical dinoprostone for cervical ripening and labor induction: A randomized comparison. Obstet Gynecol 2000;96:465-9.
Bortolus R. Determination of response to intracervical prostaglandin for cervical ripening. Eur J obstet Gynecol Reprod Biol 1999;87:137-41.
Ramsey PS, Ramin KD, Ramin SM. Labor induction. Current Opinion in Obstetrics and Gynecology 2000; 12: 463-73.
Helmin J, Moller B. Extra amniotic saline infusion is promising in preparing the cervix for induction of labor. Acta Obstet Gynecol Scan 1998; 77: 45-9.
Guinn DA, Davies JK, Jones RO, Sullivan L, Wolf D. Labor induction in women with an unfavorable Bishop score: randomized controlled trial of intrauterine Foley catheter with concurrent oxytocin infusion versus Foley catheter with extra-amniotic saline infusion with concurrent oxytocin infusion. Am J Obstet Gynecol 2004;191: 225-9.
Karjane NW, Brock EL, Walsh SW. Induction of labor using a foley balloon, with and without extra-amniotic saline infusion. Obstet Gynecol 2006; 107: 234-9.
Sherman DJ, Frenkel E, Tovbin J, Arieli S, Caspi E, Bukovsky I. Ripening of the unfavorable cervix with extraamniotic catheter balloon: clinical experience and review. Obstet Gynecol Surv 1996; 51: 621-7.
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