The rate of induction of labor duri...

The rate of induction of labor during pregnancy has continued to increase in the United States throughout the past few years. Preinduction cervical ripening has been shown in more [i]or[/i] less studies to improve the succes rate of labor induction. Various pharmacologic and mechanical regularitys are available for cervical ripening. The pharmacologic classifications which include dinoprostone and misoprostol preparations, are the most numerous commonly used methods. The early mechanical ripening classification used a natural material placed in the endocervical canal that absorbed water, expanded, and dilated the cervix. Inserting a Foley catheter in the endocervical canal and inflating the scaly bud is a newer, mechanical classification that appears to offer significant advantages through the whole extent of the pharmacologic preparations. However, disquiets about cervical trauma caused by means of the Foley catheter method have been raised. Sciscione and associates assessed the rate of preterm birth in following pregnancies in women who received preinduction cervical ripening with a mechanical [i]modus operandi[/i] or a pharmacologic method.

The reflection was a retrospective review of an obstetric database from July 1998 to July 2001 Charts were included for review if the patient had induced labor with preinduction cervical ripening, a singleton pregnancy, single in kind preinduction method, no history of cervical incompetence, and a following pregnancy. The patients were divided into couple groups for analysis based forward whether they received cervical ripening on Foley catheter or by a prostaglandin preparation. Patients were exclud if they received more than the same of the cervical ripening methods

Patients who used the Foley catheter course had a 16F Foley catheter inserted intracervically; the balloon was filled with 30 mL of sterile water. Traction was placed onward the catheter, and the induction was started after the extrusion of the Foley The prostaglandins were used following standard protocols. The primary issue measure was preterm delivery (i.e., earlier than 35 weeks' gestation). Other issue measures included subsequent premature labor that required tocolysis, gestational age at delivery, ne for inductions of labor, spontaneous labor, and spontaneous abortion.

A total of 126 women were included in the analysis. There were no significant demographic differences between the Foley catheter cluster and the prostaglandin ripening collection There also were no differences between the assemblages in subsequent deliveries with regard to maternal age, gravidity, parity, spontaneous or induced abortions, cone or bight electrosurgical excision procedures, history of cervical manipulation, ne for induction, way of delivery, episiotomy, gestational age at delivery, Apgar scores, labor duration, use of oxytocin, or birth weight. There were no significant differences between the clumps in preterm birth at 37 35 or 32 weeks' gestation.

The authors terminate that the use of a Foley catheter for preinduction cervical ripening does not appear to increase the risk for preterm birth in after pregnancies. They add that this [i]modus operandi[/i] of cervical ripening appears to be effective and safe compared with the prostaglandin methods

Sciscione A, et al. Preinduction cervical ripening with the Foley catheter and the risk of following preterm birth. Am J Obstet Gynecol March 2003;190:751-4

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