Pregnancy outcomes after failed cervical ripening with prostaglandin E2 followed by Foley balloon catheter |
| |
| Authors: | Yossi Mizrachi Michal Levy Eran Weiner Jacob Bar Giulia Barda Michal Kovo |
| |
| Affiliation: | 1. Department of Obstetrics &2. Gynecology, Edith Wolfson Medical Center, Affiliated with Sackler Faculty of Medicine, Tel Aviv University, Holon, Israelmizrachi.yossi@gmail.com;4. Gynecology, Edith Wolfson Medical Center, Affiliated with Sackler Faculty of Medicine, Tel Aviv University, Holon, Israel |
| |
| Abstract: | Objective: To study pregnancy outcomes of cervical ripening with Foley catheter, in women who failed to respond to prostaglandin-E2 (PGE2).Methods: A retrospective cohort study of all patients with a singleton pregnancy, who underwent cervical ripening with vaginal PGE2, between 2013 and 2014, was performed. Patients who failed to respond to a total dose of 6–9 mg PGE2, defined as no change in Bishop score, underwent subsequent ripening with Foley catheter (non-responders group). Data were compared to patients who achieved sufficient response to a total dose of up to 9 mg PGE2 (responders group).Results: Compared with the responders group (n?=?813), patients in the non-responders group (n?=?49) had higher rates of nulliparity (p?p?=?0.004), pre-induction cervical effacement?≤50% (p?=?0.01) and birth weight >4000?g (p?=?0.02). A significantly higher cesarean delivery rate was observed in the non-responders group (51 versus 12.3%, p?Conclusions: The need for an additional cervical ripening method after failure with PGE2 is associated with a very high risk of cesarean delivery. This is particularly significant in nulliparous women, women carrying large fetuses, and women presenting with a low Bishop score. |
| |
| Keywords: | Cervical ripening Foley catheter labor induction prostaglandins |
|
|
