Publication:

Comparison of dinoprostone slow-release vaginal insert with intracervical Foley catheter in cervical ripening for induction of labour: a prospective observational study

Background Cervical ripening prior to induction of labour is crucial as unfavorable cervix with poor Bishop’s score can lead to caesarean section. Two most widely used methods are vaginal dinoprostone and intracervical Foley catheter. Studies conducted worldwide to determine the efficacy and safety of these methods provided no consensus regarding superiority. Thereby, the present study aims to compare the efficacy of these two methods for successful cervical ripening during induction of labour.

Methods In this prospective observational study, all antenatal women admitted for induction of labour satisfying the inclusion criteria were enrolled. Women in group A were induced with dinoprostone slow-release vaginal insert and those in group B with intracervical Foley catheter. Sample size was 72 in each group. Both the groups were followed till delivery and assessed for improvement in Bishop’s score, induction to active phase duration, induction to delivery time, use of other agents, mode of delivery, incidence of hyperstimulation and neonatal outcomes.

Results Induction to active phase duration and to delivery time was statistically shorter in dinoprostone slow-release vaginal insert group than intracervical Foley group. Improvement in Bishop’s score, mode of delivery and indication for LSCS were not statistically significant. Uterine hyperstimulation was significantly higher in Dinoprostone insert group. Neonatal outcomes were similar.

Conclusions Dinoprostone slow-release vaginal insert resulted in better Bishop’s score during re assessment, reduced need for second agent, shorter induction to active phase and to delivery time when compared with intracervical Foley catheter and so can be used effectively for successful cervical ripening.