Cervical Ripening: How Long Can the Foley Catheter Safely Remain in the Cervical Canal?

Abstract

This was a prospective study involving 85 patients admitted for induction of labour with unfavourable cervix at Usman Danfodiyo University Teaching Hospital, Sokoto, Nigeria. A size 16-20 Foley catheter was passed transcervically into the extra-amniotic space under aseptic technique and the balloon inflated with 30-50mls sterile water. Each patient was placed on prophylactic antibiotics. The balloon was expelled within 12 hours in 22 (39%) patients. Twenty eight patients expelled the balloon in 12-24 hours, 14 in 25-48 hours, 6 in 49-72 hours and 4 after 72 hours. The average duration of catheter placement when the gestational age was 20-27 weeks was 44.8 hours, which was significantly longer than 19.6 hours obtained for term pregnancies (p << 0.05). Induction of labour was successful in 77 (91%) patients and there was no significant maternal morbidity. The results of our study suggest that the balloon of the Foley catheter can safely remain in the extra-amniotic space longer than 24 hours for cervical ripening if the cervix is unfavourable, provided the membranes are intact and the feto-maternal

Induction to delivery interval using transcervical Foley catheter plus oxytocin and vaginal misoprostol: A comparative study at Aminu Kano Teaching Hospital, Kano, Nigeria

“…This was comparable to the findings of Ekele and Isah[19] where the success rate for misoprostol used for IOL was 96% and that of the intracervical Foley catheter was 91%. Owolabi et al .…”

Foley catheter for cervical priming in induction of labour at University Obstetrics Unit, Colombo, Sri Lanka: a clinical audit with a patient satisfaction survey

“…We had to deflate FC at 48 h in 16 subjects (29%) with a total vaginal delivery rate of 79%. Ekele and Isah reported that most women (95%) would have expelled FC spontaneously within 72 h of insertion and a 91% vaginal delivery rate [21]. According to our results nulliparous women reported 25/32, 78% vaginal delivery rate.…”

Cervical ripening and induction of labour: Inpatient or outpatient, oral misoprostol or Foley catheter?

“…Although the Foley catheter is often removed after 24 hours due to concerns about possible ascending infections, there does not appear to be a significant increase of chorioamnionitis associated with the insertion of a Foley catheter for induction of labour. Keeping the Foley catheter up to three to four days is safe and effective for induction of labour [8,10,26,27]. However, the Foley catheter should not be inserted in the presence of overt vaginal or cervical infection, and appropriate antiseptic measures and sterile procedures should be adopted during its insertion.…”