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Papaverine prior to catheter balloon insertion for labor induction: a randomized controlled trial
Raneen Abu Shqara1, Yara Nakhleh Francis1, Gabriela Goldinfeld2
1Department of Obstetrics and Gynecology, Galilee Medical Center, Nahariya, Israel (Abu Shqara, Nakhleh Francis, Haddad, Sgayer, Lavinsky, Lowenstein, and Frank Wolf); Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel (Abu Shqara, Nakhleh Francis, Goldinfeld, Haddad, Sgayer, Lowenstein, and Frank Wolf).
Administering papaverine before Foley catheter balloon insertion improved Bishop scores and shortened labor induction-to-delivery intervals. This method enhances cervical ripening and labor progression for expectant mothers.
Area of Science:
- Obstetrics and Gynecology
- Pharmacology
Background:
- Catheter balloon insertion is a standard procedure for cervical ripening and labor induction.
- Papaverine, a smooth muscle relaxant, has been investigated for its potential to expedite childbirth.
Purpose of the Study:
- To assess the impact of papaverine administration prior to Foley catheter balloon insertion on Bishop score changes.
- To evaluate the effect of papaverine on the interval from labor induction to delivery.
Main Methods:
- A randomized, double-blinded, placebo-controlled trial involving 110 women at term with an initial Bishop score of ≤6.
- Participants received either intravenous papaverine (80 mg) or normal saline before Foley catheter balloon insertion.
- Co-primary outcomes included Bishop score change and induction-to-delivery interval; secondary outcomes assessed maternal and neonatal well-being.
Main Results:
- The papaverine group showed a significantly greater improvement in Bishop scores compared to the placebo group (P=.025).
- The median induction-to-delivery interval was shorter in the papaverine group (21 hours vs. 26 hours, P=.031).
- A higher percentage of women in the papaverine group delivered within 24 hours (65.5% vs. 41.8%, P=.012).
Conclusions:
- Papaverine administration before Foley catheter balloon insertion effectively improves cervical ripening, as indicated by enhanced Bishop scores.
- This intervention also leads to a reduced labor induction-to-delivery interval, suggesting a more efficient labor progression.
