A randomized controlled study comparing Prostaglandin E2 vaginal suppository with intra-cervical Foleys catheter balloon for preinduction cervical ripening at term

Abstract

Background: Pre-induction ripening of an unfavourable cervix reduces the incidence of failed induction and associated maternal and perinatal morbidity and mortality.

Objective: The aim of this study is to compare the effectiveness of prostaglandin E2(PGE2) vaginal suppository with intra-cervical Foley's catheter balloon for pre-induction cervical ripening.

Methods: It is a prospective randomized study. Clients with unfavourable cervix (Bishop score<5) were randomly allocated into two groups. One group received 3mg PGE2 vaginal suppository and the second group had intra cervical Foley catheter insertion and balloon inflated with 30mls of sterile water.

Results: There were 38 patients in each arm.There was no difference in age, parity and educational level, p=0.9157, 0.8054 and 0.7568 respectively, in the two groups. There were significant changes in the Bishop scores following the application of Foley's catheter and Prostaglandin E2 (p= 0.0214 and 0.0105) respectively. The cervix became ripened (Bishop score e"5) in 92.1% of clients. There was no significant difference in cervical ripening effectiveness in the two groups (p=1.0000). The average time to onset of labour (latency interval) was 12.48±3.36 hours and was significantly shorter with the PGE2 group (p=0.0494). The mean induction to delivery interval for the women was 16.33±8.25hours. There was no significant difference between the two groups (p=0.7418). There were no differences between the two groups in mode of delivery, apgar sores and neonatal admission rate.

Conclusions: PGE2 and Foley catheter balloon are equally effective as cervical ripening agents.