Syeda Batool Mazhar, Saba Sarwar, Ghazala Mahmud.
Induction Of Labour, A Randomized Trial comparing Prostaglandin E2 Pessary, Intracervical Foley Catheter and Extra Amniotic Saline Infusion.
J Surg Jan ;19-20:12-8.

The aim was to compare the efficacy and safety of two cheaper mechanical methods, intracervical Foley catheter (ICFC) and intracervical Foley catheter with extraamniotic saline infusion (EASI) with prostaglandin E2 vaginal pessary for cervical ripening and induction of labour, in term pregnant women with modified Bishop score * 6. 307 pregnant women requiring induction of labour at term, were randomized to one of the three following modes of induction, 3 mg prostaglandin E2 vaginal pessary, 2 doses, 6 hours apart, ICFC and EASI for 12 hours unless spontaneously expelled earlier. All patients had artificial rupture of membranes (ARM), 12 hours post induction or on spontaneous expulsion of catheter. Syntocinon infusion was commenced at the time of membrane rupture. <p> After seven exclusions, 100 women were included in each arm. The groups had similar demographic characteristics. The mean modified Bishop score at 12 hours post induction was 5.9, 6.3, 6.2, for PGE2, ICFC and EASI respectively. The mean insertion to delivery time interval was 15.7, 17.3, 16.1 hours for PGE2, ICFC and EASI respectively. The cesarean section rates were 16% in the PGE2 and ICFC group and 14% for EASI group. The three modes of induction are equally effective and safe. The mechanical methods have additional potential advantage of low cost and reversibility. Conclusion: In conclusion, the mechanical methods were inexpensive, safe and well tolerated when compared with prostaglandin E2 vaginal pessary. In the EASI category, women reported minor discomfort of wetness and reduced mobility while the women in ICFC were ambulant. Moreover the results of EASI when compared to ICFC were also strikingly similar.

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Posted by: on Mar 2002

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