Membrane sweeping versus transcervical Foley catheter for induction of labor in women with a previous cesarean delivery: a randomized controlled trial.

Background: This study aimed to compare the effectiveness of membrane sweeping and transcervical Foley catheters for the induction of labor after one previous cesarean delivery.

Methods: An open-label, prospective, randomized controlled trial was performed at Sibu Hospital, Sarawak, Malaysia between 15^th February 2018 and 30^th August 2018. Pregnant women aged 18 or above at term who had one previous uncomplicated lower segment cesarean section and required induction of labor were randomized to membrane sweeping or transcervical Foley catheter insertion.

Results: A total of 60 women were recruited in the study, of whom 30 were randomized to the membrane sweeping group and 30 to the Foley catheter group. The number of women who achieved a Bishop Score ≥8 was significantly higher in the Foley catheter arm than in the membrane sweeping arm (76.7% versus 43.3%; P=0.008). Compared with membrane sweeping, transcervical Foley catheter insertion significantly improved Bishop scores and allowed more women to achieve a favorable cervix that permitted an amniotomy by 48 hours of labor induction (P<0.05). The mode of delivery, intrapartum oxytocin use, maternal complications and neonatal outcomes were similar in both groups. No women had a uterine rupture or uterine hyperstimulation.

Conclusions: Although transcervical Foley catheter insertion is superior to membrane sweeping in terms of the efficacy of labor induction, both methods did not show a statistically significant difference in vaginal delivery rates and their overall complication rates were similar.