Vaginal prostaglandin-E2 suppository versus extra-amniotic Foley catheter to induce labor: A randomized clinical trial

Abstract

The aim of the present study was to compare the effect of vaginal prostaglandin-E2 suppository with the insertion of Foley catheter in extra amniotic space to induce labor. In a randomized clinical trial study the effect of vaginal prostaglandin-E2 suppository was compared with insertion of Foley catheter in extra amniotic space. The study participants were 44 nulliparous pregnant women presenting with term pregnancy in their 38-42 weeks of gestation. The mean time interval between induction and vaginal delivery was 12.8 hours for extra-amniotic Foley catheter and 12 hours for vaginal prostaglandin-E2 group without statistical significance. Mean time to effective uterine contractions was 8.22(2.6) hours in extra-amniotic Foley catheter group versus 9(4) hours in vaginal prostaglandin-E2 group without statistically significant difference. Mean Bishop's score six hours after induction was 6.22(1.8) in extra-amniotic Foley catheter group versus 4.6(2.5) in vaginal prostaglandin-E2 group and the difference was statistically significant (P < 0.05). Mean time from induction to a Bishop's score above 7, mean oxytocin dose, and mean neonatal APGAR score didn't statistically differ between the groups. The women in extra-amniotic Foley catheter group were 1.6 times more likely to have vaginal delivery compared to those in vaginal prostaglandin-E2 group(Risk ratio=1.64, 95% CI: 1.03-2.59). Conclusions: In our study, vaginal prostaglandin-E2 suppository and extra-amniotic Foley catheter appeared to be comparable for labor induction. Considering the fact that extra-amniotic Foley catheter has advantages such as simplicity, low cost, reversibility, and lack of systemic or serious side effects, it may be preferred by clinicians.