Foley catheter and controlled release dinoprostone versus foley catheter labor induction in nulliparas: A randomized trial

Document Type

Article

Publication Date

10-1-2022

Abstract

Purpose To evaluate Foley catheter and controlled release dinoprostone insert compared to foley catheter alone on induction to delivery interval and maternal satisfaction. Methods A randomized trial was conducted in a university hospital in Malaysia from December 2018 to May 2019. Term nulliparas with unfavorable cervix (Bishop score <= 5) scheduled for labor induction were randomized to Foley catheter and controlled release dinoprostone insert simultaneously or Foley catheter alone. Primary outcomes were induction to delivery interval (hours) and maternal satisfaction on birth experience (assessed by 11-point Visual Numerical Rating Scale VNRS 0-10, higher score more satisfied). Results Induction to vaginal delivery intervals was mean +/- standard deviation 22.5 +/- 10.4 vs. 35.1 +/- 14.9 h, P = < 0.001 but maternal satisfaction on birth experience was not significantly different medianinterquartile range] VNRS 87-9] vs. 87-9], P = 0.12 for Foley catheter-controlled-release dinoprostone and Foley catheter alone arms, respectively. Cesarean delivery rates were 35/102(34.3%) vs. 50/101(49.5%), P = 0.02 RR 0.7 95% CI 0.5-0.9 NNTb 6.3 95% CI 3.5-39.4, pain score at 6 h after catheter insertion 52-8] vs. 11-3], P < 0.001, Bishop score at trial devices removal 99-10] vs. 87-9], P = 0.001, requirement for oxytocin induction or augmentation 39/102(38.2%) vs. 76/101(75.2%) NNTb 3 95% CI 2.0-4.1, P < 0.001 and amniotomy rates 73/99(73.7%) vs. 81/95(85.3%), P = 0.052 RR 0.9 85% CI 0.8-1.0 in Foley catheter-controlled-release dinoprostone and Foley catheter alone arms respectively. Conclusion In nulliparas with unripe cervixes at term, combined Foley catheter and controlled release dinoprostone vaginal insert compared to Foley catheter alone reduces the induction to vaginal delivery interval and cesarean delivery rate but satisfaction was not significantly increased.

Keywords

Labor induction, Controlled release dinoprostone, Dinoprostone insert, Foley catheter, Cesarean, Vaginal delivery, Maternal satisfaction, Induction to vaginal delivery interval

Divisions

obstetrics

Funders

Department of Obstetrics and Gynecology, University of Malaya (Grant No: UMSCOG/RF00142018/01)

Publication Title

Archives of Gynecology and Obstetrics

Volume

306

Issue

4

Publisher

Springer Verlag (Germany)

Publisher Location

TIERGARTENSTRASSE 17, D-69121 HEIDELBERG, GERMANY

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