Transcervical Foley catheter with and without extraamniotic saline infusion for labor induction: a randomized...

Area of Science:

• Obstetrics and Gynecology
• Reproductive Medicine
• Clinical Trials

Background:

• Cervical ripening and labor induction are critical in managing pregnancies with unfavorable cervices.
• Transcervical Foley catheter is a common method for cervical ripening.
• Extraamniotic saline infusion is an adjunct method sometimes used with Foley catheters.

Purpose of the Study:

• To compare the efficacy of transcervical Foley catheter alone versus Foley catheter with extraamniotic saline infusion for labor induction.
• To assess cervical ripening effectiveness in women with an unfavorable cervix.

Main Methods:

• Multicenter, randomized, controlled trial involving 188 women with unfavorable cervices (Bishop score ≤6).
• Participants were randomized to receive either a Foley catheter alone or Foley catheter with extraamniotic saline infusion.
• Concurrent oxytocin administration was used in all women; intent-to-treat analysis was performed.

Main Results:

• No significant difference in the median induction-to-delivery interval between the extraamniotic saline infusion group (12.6 hours) and the Foley catheter alone group (13.4 hours).
• Comparable rates of delivery within 24 hours (89.7% vs. 87.9%) and cesarean delivery (27.8% vs. 18.7%) between the groups.
• No significant differences in maternal infectious outcomes or immediate neonatal outcomes were observed.

Conclusions:

• The addition of extraamniotic saline infusion to a transcervical Foley catheter does not enhance labor induction efficacy in women with an unfavorable cervix.
• Foley catheter alone is as effective as the combined method for labor induction and cervical ripening in this population.