Comparative Study for Labor Induction with the Foley Catheter and Double Balloon (cook) Catheter in Women with Unfavorable Cervix

Objective: The aim of this study is to compare the efficacy of single- and double-balloon catheters for the induction of labor among women with an unripe cervix. Study design: This prospective randomize interventional study was performed in emergency department of Obstetrics and Gynecology, Zagazig University and ELGALAA maternity hospitals during the period from 6/2017 till 2/2018. In this study (180 patients) who fulfill inclusion and exclusion criteria were enrolled and were divided into two main groups; single and double balloon group. Each group included equal number of prim gravida and multigravida. Result Of 180 pregnant women recruited in this study 160 continued till the end of the study. Pain encountered by using visual analogue scale during the catheter insertion the mean pain perception during catheter insertion was 3.3 ± 2.3 in the Foley catheter group and 3.1 ± 2.47 in the Cook catheter group. In the Foley catheter group there were significantly more spontaneous expulsions of the balloon compared with the Cook balloon group. In the Foley catheter group 82.2% of them delivered vaginally and 17.8% delivered by caesarean section. In cook catheter group 80% of them delivered vaginally and 18% delivered by caesarean section. Regarding maternal complications There were 4 cases of postpartum hemorrhage (PPH), 3 of them were atonic PPH, and only one case with traumatic PPH due to cervical tear in the Cook catheter group and in foley catheter group there were 3 cases of postpartum hemorrhage all of them atonic postpartum. Conclusion: 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. 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.