Combinet labor preinduction by Fole catheter with prostaglandins E1 and E 2: prospective randomised study
Abstract
Objectives: To identify the most effective and safest method of labour preinduction. Study type: Prospective randomized open label study.
Setting: Department of Gynecology and Obstetrics, Institute for Mother and Child Care, Prague, Czech Republic. Methods: In ou study we prospectively investiqated combined preinduction methods based on intracervical insertion of Foley catheter with concomitant oral administrativ of prostaglandin E1 (Angusta 25 µg) or concomitant vaginal administrativ of prostaglandin E2 (Prostin 3 mg).
We compared these datwith the sequential use of Foley cathether or prostaglandin E2 (Foley catheter day 1, prostaglandin day 2). In mothers, we monitored the percentage of vaginal and optative births, the incidence of uterine hyperstimulations, severe bleeding and perineal injuries (perineal grade III and IV ruptures).
In neonates, we monitored Apgar scores and umbilical cord pH. All patients who did not contraindication to induction of labour were included in the study.
Results: A total of 230 patients undergoing preinduction in UPMD were included in our study. In the period (8-9/2021) of the use of combined methods, the induction time decreased (from 31 h to 20 h; p = 0.0005) compared to sequential methods (3-4/2021), but the number of complications increased (From 9.9 % to 24.4 %; p = 0.005).
The percentage of caesarean sections was comparable in both groups (32.4 v, 28.6; nonsignificant [NS)). We did not find a significant difference between the groups combining -- Foley catheter + oral administration of prostaglandin El and Foley catheter + vaginal administration of prostaglandin E2, but in the group with vaginal administration of prostaglandin E2 we observed a tendency to have a higher percentage of complications.