Induction of labor in nulliparous women with unfavorable cervix: a comparison of Foley catheter and vaginal prostaglandin E2

Abstract

Purpose: To compare maternal and neonatal outcomes of two methods of labor induction in nulliparous women with unfavorable cervix.

Methods: A case-control study was performed on nulliparous women with a cervical Bishop score < 6, who underwent induction of labor with either extra-amniotic Foley catheter (Foley catheter study group) or vaginal tablets of prostaglandin E2 (PGE2 control group). The control group was matched for gestational age and for the indication to induce labor.

Results: A total of 346 nulliparous women were included. Similar rates of cesarean delivery were found in the Foley catheter and the PGE2 groups (25.4 vs. 24.2 %, respectively, p = 0.8), without differences in maternal or neonatal adverse outcomes. In the Foley catheter group, induction to delivery interval was shorter compared with the PGE2 group (25.1 vs. 36.6 h, respectively, p < 0.001), and more women delivered within 24 h (55.0 vs. 40.4 %, respectively, p = 0.01).

Conclusion: Induction of labor with Foley catheter in nulliparous women with unfavorable cervix is associated with shorter induction to delivery interval, but with similar rates of cesarean deliveries and adverse pregnancy outcomes, as compared with vaginal tablets of PGE2.

Keywords: Foley catheter; Labor induction; Nulliparity; Prostaglandins.