Foley balloon catheter versus oral misoprostol for induction of labour
after PROM: a retrospective data analysis.
Abstract
Objective. The Foley balloon catheter (FC) is a viable method for
cervical ripening, but concerns about infection risk restrict its use in
cases of prolonged prelabour rupture of membranes (PROM). This study
aims to evaluate the efficacy and safety of the FC compared to oral
misoprostol for cervical ripening after PROM. Design. A retrospective
data-analysis. Setting. Two Dutch teaching hospitals. Population. 128
pregnant women underwent cervical ripening after ≥ 24 hours of PROM at
37-42 weeks’ of gestation. Main outcome measures. The incidence of
intrapartum infection, as a composite of maternal and neonatal
infection. In addition, we evaluated the mode of delivery, duration of
priming and priming-to-delivery interval. Results. The incidence of
intrapartum infection was higher in the FC group compared to oral
misoprostol, respectively 32.7% (n = 16) vs. 12.7% (n = 10) (p =
.006). However, after adjusting for epidural anaesthesia and
pregestational BMI, the association was no longer significant. No
difference was found in mode of delivery. The total priming-to-delivery
interval was similar in both groups (median 21.3 hour vs. 22.0, p =
.897). The duration of cervical ripening was shorter in the misoprostol
group and duration of active labour longer (p <.001).
Conclusion. In women who require cervical ripening after prolonged PROM
at term, FC and oral misoprostol are similar in terms of efficacy and
safety. Funding. The authors received no financial support.