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Foley catheter compared with the controlled-release dinoprostone insert: a randomized controlled trial.

Rodney K Edwards1, Jeff M Szychowski, Jessica L Berger

  • 1University of Alabama Birmingham School of Medicine, the Center for Women's Reproductive Health, Birmingham, Alabama; Magee Women's Hospital of the University of Pittsburgh Medical Center, Department of Obstetrics, Gynecology and Reproductive Sciences, Pittsburgh, Pennsylvania; the Department of Obstetrics and Gynecology, University of California Davis, Sacramento, California; and Phoenix Perinatal Associates, Maternal-Fetal Medicine, Obstetrix/Mednax, Phoenix, Arizona.

Obstetrics and Gynecology
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Summary
This summary is machine-generated.

Foley catheter use for labor induction significantly reduced time to delivery and increased the rate of vaginal births within 24 hours compared to dinoprostone inserts. Cesarean delivery rates were similar between groups.

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Area of Science:

  • Obstetrics and Gynecology
  • Reproductive Medicine
  • Clinical Trials

Background:

  • Induction of labor is common for pregnancies at or near term.
  • Cervical ripening agents are frequently used to initiate labor.
  • Comparing Foley catheter and dinoprostone for labor induction is clinically relevant.

Purpose of the Study:

  • To compare the efficacy of Foley catheter versus dinoprostone vaginal insert for initiating labor induction.
  • To evaluate time to delivery and delivery outcomes in women undergoing labor induction.

Main Methods:

  • A multicenter randomized controlled trial was conducted.
  • Women at 36 weeks gestation or greater with an unfavorable cervix were randomized.
  • Participants received either a Foley catheter (30 mL) or dinoprostone for up to 12 hours.

Main Results:

  • Foley catheter use resulted in shorter time to delivery (median 21.6 vs. 26.6 hours) and higher delivery rates within 24 hours (56% vs. 40%).
  • Vaginal delivery within 24 hours was more frequent with Foley catheter (44% vs. 30%).
  • Cesarean delivery rates (29% vs. 39%) and tachysystole rates (0% vs. 3%) were not significantly different.

Conclusions:

  • Initiating labor induction with a Foley catheter is more effective than dinoprostone.
  • Foley catheter use leads to faster delivery and higher rates of vaginal birth within 24 hours.
  • Both methods showed comparable safety profiles regarding cesarean delivery and tachysystole.