Induction of labour in primigravidas with Foley’s catheter and prostaglandin E 2 tabletversus Prostaglandin E 2 tablet alone: a randomized control trial in a tertiary care hospital

Abstract

Background: Induction of labour is a method of initiation of labour to deliver the baby vaginally. It has been practised since the 18^th century. A lot of research has been carried out on the different available methods i.e mechanical and pharmacological. However research on the combination of these methods is scarce. Thus this study was carried out to compare vaginal PGE2 with the simultaneous useof PGE2 and Foleys catheter for induction of labour in primigravidas.

Material and methods :Objective: To compare the efficiency of Foleys catheter and Prostaglandin E2 pessary with ProstaglandinE2 alone in induction of labour in primigravidas     Study DesignRandomized controlled trial.Sample size 200 (100 patients in each group)

Sampling technique: randomizationSettingsObs/Gyn department DHQ teaching hospital Rawalpindi.

Inclusion criteria All primigravida needing IOL from 37 completed weeks

Exclusion criteriaAll multigravida, gestation less than 37 completed week, patient not giving consent.Data collection ProcedureData was recorded on a preformed proforma after taking informed consent.

Data analysisSPSS version 21 was used for entry and analysis of data. Data was stratified for age, gestational age, induction delivery interval, duration of labour, mode of delivery and maternal and fetal complications. Post stratification both groups were compared for efficacy by using chi-square test p-value < 0.05 was considered significant.ResultsThe parameters of maternal age  gestational age, initial bishop score maternal and fetal complications were comparable in the two groups. The induction to delivery interval was seen to be less for group A as compared to group B(10.9 hours vs 13.4 hours). The number of doses required for ripening of the cervix were also less for group A than group B. The mode of delivery was spontaneous vaginal delivery in 70(69.3%) in group A whereas it was 55(55%) in group B (p-value <0.05) Caesarean section was done in 31% as compared to 9.3% for fetal distress in group A and B respectively(p value<0.05)

Conclusion: It can be seen that there is a greater chance of vaginal delivery with the simultaneous use of Foleys catheter with PGE2  for induction of labour, in primigravida, as compared to PGE2 used alone. Moreover the disadvantages of prostaglandins can also be overcome by this method.