Labor Induction With a Foley Balloon Inflated to 30 mL Compared With 60 mL

Delaney, Shani; Shaffer, Brian L; Cheng, Yvonne W.; Vargas, Juan; Sparks, Teresa N.; Paul, Kathleen; Caughey, Aaron B.

doi:10.1097/aog.0b013e3181dec6d0

Cited by 94 publications

(83 citation statements)

References 18 publications

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“…The Foley bulb was placed just above the level of the internal os and inflated with 60cc of sterile water. 6, 7, 11, 14 The catheter was taped to the inner thigh with gentle traction and deflated and removed after 12 hours if still in place. The oxytocin protocol was initiated once the Foley bulb was no longer in place (Appendix 2, http://links.lww.com/xxx).…”

Section: Methodsmentioning

confidence: 99%

Mechanical and Pharmacologic Methods of Labor Induction

Levine

Downes

Elovitz

et al. 2016

Obstetrics &Amp; Gynecology

126

109

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Objective To evaluate the effectiveness of four commonly used induction methods. Methods This randomized trial compared four induction methods: Misoprostol alone, Foley alone, Misoprostol–cervical Foley concurrently, and Foley–oxytocin concurrently,. Women undergoing labor induction with full term (≥37 weeks), singleton, vertex presenting gestations, with no contraindication to vaginal delivery, intact membranes, Bishop score ≤6, and cervical dilation ≤2cm were included. Women were enrolled only once during the study period. Our primary outcome was time to delivery. Neither patients nor providers were blinded to assigned treatment group since examinations are required for placement of all methods; however, research personnel were blinded during data abstraction. A sample size of 123 per group (N=492) was planned to compare the four groups pairwise (P≤.008), with a 4-hour reduction in delivery time considered clinically meaningful. Results From May 2013 through June 2015, 997 women were screened and 491 were randomized and analyzed. Demographic and clinical characteristics were similar among the four treatment groups. When comparing all induction method groups, combination methods achieved a faster median time to delivery than single-agent methods, (misoprostol–Foley: 13.1 hours, Foley–oxytocin: 14.5 hours, misoprostol: 17.6 hours, Foley: 17.7 hours, p<0.001). When censored for cesarean and adjusting for parity, women who received misoprostol–Foley delivered almost twice as likely to deliver before women who received misoprostol alone (hazard ratio (HR, 95% CI) 1.92 [1.42–2.59]) or Foley alone (HR, 95%CI: 1.87 [1.39–2.52]), whereas Foley–oxytocin was not statistically different from single-agent methods. Conclusion After censoring for cesarean and adjusting for parity, misoprostol–cervical Foley resulted in twice the chance of delivering before either single-agent method.

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Section: Methodsmentioning

confidence: 99%

Mechanical and Pharmacologic Methods of Labor Induction

Levine

Downes

Elovitz

et al. 2016

Obstetrics &Amp; Gynecology

126

109

View full text Add to dashboard Cite

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“…There is evidence that a higher volume Foley (60 or 80 ml) is more effective than one of 30 ml. 25,26 Additionally, four studies used a 50 lg dose of misoprostol, which is considered a second-choice dose, as it is associated with an increased risk of tachysystole. 22 Because of this, we controlled for the Foley balloon volume, misoprostol dose and misoprostol frequency in our analysis.…”

Section: Discussionmentioning

confidence: 99%

Intravaginal misoprostol versus Foley catheter for labour induction: a meta-analysis

Fox

Roman³

et al. 2011

BJOG: An International Journal of Obstetrics &Amp; Gynaecology

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Background There are a number of agents used for cervical ripening prior to the induction of labour. Two commonly used agents are intravaginal misoprostol and a transcervical Foley catheter.Objective To review the evidence comparing misoprostol and transcervical Foley catheter placement for induction of labour, and perform a meta-analysis comparing these two induction agents.Search strategy We conducted database searches of PubMed, Embase, the Cochrane Library Database, and the ClinicalTrials.gov website. Bibliographies of all relevant articles were reviewed.Selection criteria Prospective, randomised trials comparing the use of intravaginal misoprostol and transcervical Foley catheter for the purpose of cervical ripening and induction of labour were included. We excluded studies in which the patients in these two intervention groups also received other induction agents concurrently, such as oral misoprostol, oxytocin, or other prostaglandins.Data collection and analysis The primary outcomes selected were time to delivery, and the rates of caesarean section, uterine tachysystole, and chorioamnionitis. Random-effects generalised linear models with a poisson distribution and log link function were used to compare the two induction agents across the studies.Main results Nine studies (1603 patients) were identified as eligible to be included in this meta-analysis. There were no significant differences in the mean time to delivery (mean difference 1.08 ± 2.19 hours shorter for misoprostol, P = 0.2348), the rate of caesarean delivery (RR 0.991; 95% CI 0.768, 1.278), or in the rate of chorioamnionitis (RR 1.130; 95% CI 0.611, 2.089) between women who received misoprostol compared with transcervical Foley catheter. Patients who received misoprostol had significantly higher rates of tachysystole compared with women who received a transcervical Foley catheter (RR 2.844; 95% CI 1.392, 5.812).Conclusions Intravaginal misoprostol and transcervical Foley catheter have similar effectiveness as induction agents. Transcervical Foley catheter is associated with a lower incidence of tachysystole.

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“…Indeed, recent studies have started evaluating the role of adjuvant interventions to shorten the overall duration of inducedlabor and also to improve its outcome using misoprostol [6,7]. This study was therefore designed to compare outcome on labor induction in women with prolonged pregnancy and unfavorable cervix using sequential intracervical Foley catheter with intravaginal misoprostol and intravaginal misoprostol only.…”

Section: Introductionmentioning

confidence: 98%