Abstract
Author(s): Malitha Patabendige (ACDEF), Asanka Jayawardane (ABCDEF)
Introduction. The Foley catheter has shown to be a safe, effective and relatively feasible mechanical method of cervical priming in induction of labour (IOL). We evaluated indications, effectiveness, patient acceptability and outcomes of Foley catheter practicing according to the ward protocol in our unit. Matherial i Method. A clinical audit with a patient satisfaction survey conducted in University Obstetric Unit, Colombo, Sri Lanka. Patients selected for IOL for Obstetric reasons were offered with Foley as per ward protocol. All the women had singleton pregnancies with cephalic presentation, intact membranes and period of gestation of 37 weeks or above. However, women with a history of caesarean section or previous uterine surgery, low-lying placenta and suspected fetal compromise were excluded from the study. In patients who had a Modified Bishop score (MBS) of less than 3, a 16Fr Foley catheter was inserted into cervical canal. Patient satisfaction for Foley insertion was assessed with regards to the degree of discomfort using a visual analogue scale (0-10). Results. Fifty six women were primed with Foley catheters. Gestational diabetes and post term were commonest indications. Thirty two (57.1%) were nulliparous. During induction of labour, 53(94.6%) reported mild or no discomfort. Median (IQR) duration of Foley-in-situ was 30(23-48) hours. In Foley catheter only cases had 5 Caesarian sections and 31 vaginal deliveries and Foley/ prostaglandin group had 7 Caesarian sections and 13 vaginal deliveries. Subjects who had Foley only have a lesser chance of getting a caesarean section compared to those subjects who had Foley followed by prostaglandin (Relative risk = 0.40, 95% CI = 0.15- 1.09, P = 0.09). Conclusions. Foley catheter is a good choice for pre-induction cervical priming in our unit with high patient comfort and can safely be applied instead of prostaglandins.