A Comparison of Effectiveness of Hydrostatic Membrane Sweeping with Intracervical Foley’s Catheter Ballooning Alone in Pre Induction Cervical Ripening

Abstract

Induction of labor is a keystone in modern obstetric practice and a safe procedure. The success of induction, however depends upon whether the cervix is ripe or unripe. Hydrostatic membrane sweeping is a better option as this is more effective and can be used in situations where pharmacological methods are contraindicated. Study design: Randomised clinical trial. Place and duration: Department of obstetrics and gynaecology unit II, Punjab Medical College and affiliated hospitals, Faisalabad from 15-12-2008 to 15-6-2009. Subjects and methodology: 260 Patients each in group A and B were randomly assigned for cervical ripening by Foley’s catheter ballooning alone (foley) and hydrostatic membrane sweeping (HMS) method respectively. The patients were reassessed at the time of spontaneous expulsion of the catheter or at the onset of effective uterine contractions or after 18 hours of insertion. Amniotomy was done and  

syntocinon infusion was started at this point. The improvement in Bishop score and mode of delivery were studied. Results:  260 patients were allocated each in Group A and B. Improved Bishop score (>8) was achieved in 67.3% (175/260) of patients in Group A and 76% (197/260) of patients in Group B. Out of 260 patients in Group A 70% (182) had vaginal delivery and 30% (78) were delivered by caesarean section. In Group B, out of 260 patients, 78% (203) delivered vaginally and 22% (57) by caesarean section. P value was 0.036. Conclusion: Both Foley’s catheter ballooning and hydrostatic membrane sweeping are effective methods of cervical ripening however the later was more effective for improvement in Bishop Score and in achieving vaginal delivery.