DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20173488

A comparative study of induction of preterm vaginal delivery at 20 to 28 weeks gestation in previous one lower segment caesarean section by foley catheter and prostaglandin E2 gel

Shruti Agarwal, Neelam Bharadwaj, Lata Rajoria, Indira Lamba

Abstract


Background: The aim of the study to assess the maternal outcome and safety of induced preterm vaginal birth after a previous one lower segment caesarean delivery.

Methods: In this study, 100 women who had singleton pregnancies with a previous one term lower segment caesarean section, in whom induction of labour was required in between 20 to 28 wks of gestation, were included. Group A (n= 50) were induced by transcervical foley catheter and group B (n= 50) were induced by prostaglandin E2 gel and then progression of labour was monitored. Both groups were compared in terms of induction delivery interval, efficacy and safety.

Results: In our study, all women were delivered vaginally and hysterotomy was not required. The mean induction delivery interval in Foley catheter group (20.180±3.3499 hrs) was significantly shorter (p-value <0.001) than PGE2 gel group B (24.050±3.6537 hrs). There was no case of uterine rupture, puerperal pyrexia, postpartum haemorrhage and uterine hyperstimulation.

Conclusions: Women with previous lower segment caesarean section in whom premature induction of labour is required for any reason can be done easily, safely and effectively without maternal morbidity. Induction can be done more effectively by using transcervical foley catheter than intracervical prostaglandin E2 gel. It has shorter induction delivery interval and low complication. Hence, I suggest that every woman with previous one lower segment caesarean section who requires premature induction should go for trial of labour before repeating caesarean section.


Keywords


Caesarean, Foley catheter, Induction, Preterm, Prostaglandin E2 gel

Full Text:

PDF

References


Jani R, Munshi D. Management of pregnancy with previous lower segment caesarean section in Modern obstetric practice. NHL J Med Sci. 2013;2(2):59-63.

Dutta DC “Textbook of obstetrics” 7th edition; 2011;34:522-31.

Kelly AJ, Malik S, Smith L, Kavanagh J, Thomas J. “Vaginal prostaglandin (PGE2 and PGF2α) for induction of labour at term”. Cochrane Database Syst Rev. 2009;4:CD003101.

Ziyauddin F, Hakim S, Beriwal S. The transcervical foley catheter versus the vaginal prostaglandin e2 gel in the induction of labour in a previous one caesarean section–a clinical study. JCDR. 2013;7(1):140.

Jastrow N, Demers S, Chaillet N. Lower uterine segment thickness to prevent uterine rupture and adverse perinatal outcomes: a multicenter prospective study. Am J Obstet Gynecol. 2016;215(5):604.e1-604.e6.

Mizrachi Y, Levy M, Bar J, Kovo M. Induction of labor in nulliparous women with unfavorable cervix: a comparison of Foley catheter and vaginal prostaglandin E2. Arch Gynecol Obstet. 2016;294(4):725-30.

American College of Obstetricians and Gynaecologists: Vaginal birth after previous caesarean delivery; 2011.

RCOG guidelines. Birth After Previous Caesarean Birth Green-top Guideline; 2015:45.

Jozwiak M, Hilde A, Van De Lest, Burger B, Marja GK, Dijksterhuis and Jan Willem De Leeuw. Cervical ripening with Foley catheter for induction of labor after caesarean section: a cohort study. Acta Obstet Gynecol Scand. 2014;93(3):296-301.