TUESDAY, Oct. 25 (HealthDay News) -- Women who undergo labor induction with a Foley catheter have a comparable cesarean section rate but fewer side effects than women induced with vaginal prostaglandin E2 gel, according to a study published online Oct. 25 in The Lancet.
Marta Jozwiak, M.D., from the Groene Hart Hospital in Gouda, Netherlands, and colleagues compared the safety and effectiveness of inducing labor with a Foley catheter versus using vaginal prostaglandin E2 gel induction. A total of 824 women with term singleton pregnancy in cephalic presentation, unfavorable cervix, intact membranes, an indication for labor induction, and no history of cesarean section were randomized to induction of labor with either a 30 mL Foley catheter or with vaginal prostaglandin E2 gel. The cesarean section rate was the primary outcome, and secondary outcomes included maternal and neonatal morbidity and time from intervention to birth.
The investigators found that the Foley catheter and prostaglandin groups had similar cesarean section rates (23 and 20 percent, respectively; risk ratio, 1.13; 95 percent confidence interval, 0.87 to 1.47). A meta-analysis that included data from this trial confirmed no reduction in the cesarean section rates by using the Foley catheter method. Two serious maternal adverse events (one uterine perforation and one uterine rupture) were observed in the prostaglandin group.
"In women with an unfavorable cervix at term, induction of labor with a Foley catheter is similar to induction of labor with prostaglandin E2 gel, with fewer maternal and neonatal side-effects," the authors write.