الفهرس 
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Abstract
Induction of labor should be used in the most efficient way possible that will result in a favorable obstetric outcome with minimum fetal morbidity.
This is a comparative study between Foley catheter and double balloon catheter for pre-induction cervical ripening in post term pregnant patients with unfavorable cervix.
Our aim in this study was to compare the efficacy of Foley catheter and double balloon catheter for pre-induction cervical ripening in post term pregnancy. We also aim to assess safety and patient acceptability with the two methods.
This study was carried out in emergency department of Obstetrics and Gynecology, Suez Canal University hospital on 156 post term pregnant females who were divided into two groups each contained 78 women as follows:
In group 1, a single-balloon catheter group: An 18-French Foley catheter was inserted above the internal cervical os and filled with 50 mL of normal saline. The catheter was strapped to the inner aspect of one leg after tension.
In group 2, a double-balloon catheter group: A double-balloon catheter (Cook Cervical Ripener Balloon, Cook OB/GYN) was inserted through the cervix, and balloons on either side of the cervix were inflated with 80 mL of normal saline. The catheter was taped to the inner thigh, without tension, for patient comfort, because the two balloons place pressure on the cervical os.
For Foley and double balloon catheter, non-stress test was conducted after catheter insertion. Removal of the catheter was planned at approximately 12 hours after insertion if spontaneous expulsion had not
Summary and Conclusion
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occurred. In cases whom labor did not begin spontaneously after removal or spontaneous expulsion of the catheter, artificial rupture of the membranes and oxytocin infusion were commenced. Continuous electronic fetal monitoring was used throughout established labor. Labor progress abnormalities were diagnosed and managed.
Failed induction of labor was defined as failure to progress to the active phase 12 hours after water breakage combined with oxytocin. Analgesia was administered at maternal request.
There was no statistically significant difference between the two groups regarding pain with catheter insertion, risk of caesarean delivery, Apgar score post-delivery, maternal complications and patient satisfaction with the method used.
But there is significant difference between the two groups regarding Bishop Score after the balloon catheter expulsion or removal and it was significantly higher in the Cook cervical ripening balloon group, but only in the nulliparous group.
Also there is significant difference between the groups in the number of cases with spontaneous expulsion of the catheter which is more in Foley catheter group, insertion to expulsion time which is more in double balloon catheter group, insertion to delivery time which is shorter in Foley catheter group.
Putting in mind that the Foley catheter is cheaper than double balloon catheter and at least as effective as Cook catheter or even better, it is recommended to use Foley catheter in induction of labor instead of double balloon catheter.