Efficiency of the Foley catheter versus the double balloon catheter during the induction of second trimester pregnancy terminations: a randomized controlled trial
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To compare induction-to-delivery intervals of Foley catheters and double balloon catheters in second trimester pregnancy terminations.
This randomized parallel study was conducted on women who underwent second trimester terminations between December 2016 and December 2017. Pregnant women in the second trimester with a Bishop score < 6 were included in the study. Participants were randomized into two groups, the first being the Foley catheter group and the second being the double balloon catheter group. The time frames from insertion of catheters to the delivery were recorded in each group. A multiple regression analysis was carried out to examine the contribution of factors to the induction-to-delivery interval. A survival analysis was conducted to compare the Foley method and the double balloon method.
A total of 91 pregnant women were included in the final analysis. The induction-to-delivery interval was shorter in the Foley catheter group than in the double balloon catheter group (38 h 54 min ± 21 h 6 min versus 58 h 17 min ± 25 h 56 min). We also found that women with intrauterine fetal death (IUFD) had a shorter time to delivery compared to women with live fetuses (39 h 12 min ± 18 h 46 min vs 51 h 30 min ± 26 h 42 min, p = 0.04). Women with a history of vaginal delivery also had a shorter induction-to-delivery time compared to women who never delivered vaginally before (38 h 12 min ± 17 h 42 min vs 53 h 54 min ± 27 h 18 min, p = 0.004). In the multiple regression analysis, the most significant contributor to the induction-to-delivery time was the method used for induction of labor and followed by other factors including the viability of the fetus (live/IUFD), history of vaginal delivery and PPROM. The survival analysis showed that the induction-to-delivery interval was significantly shorter in the Foley catheter group than in the double balloon catheter group (HR 2.51, 95% CI 1.57–4.00, p = 0.001).
During the termination of second trimester pregnancies time from induction of labor to delivery is shorter with the Foley catheter compared to double balloon catheter.
KeywordsSecond trimester Pregnancy termination Foley catheter Double balloon catheter
GD: Data collection, manuscript writing. BAÇ: Manuscript writing, data analysis. BAM: Manuscript editing, data analysis. NK: Data collection. GY: Project development.
Compliance with ethical standards
Conflict of interest
The author declares that they have no conflict of interest.
All procedures performed were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 2.(2013) ACOG Practice Bulletin No. 135: Second-trimester abortion. Obstet Gynecol 121(6):1394–1406. https://doi.org/10.1097/01.aog.0000431056.79334.cc
- 5.Velipasaoglu M, Ozdemir CY, Ozek B, Ayaz R, Tanir HM (2018) Sequential use of Foley catheter with misoprostol for second trimester pregnancy termination in women with and without caesarean scars: a prospective cohort study. J Matern Fetal Neonatal Med 31(5):677–681. https://doi.org/10.1080/14767058.2017.1293037 CrossRefPubMedPubMedCentralGoogle Scholar
- 6.Rezk MA, Sanad Z, Dawood R, Emarh M, Masood A (2015) Comparison of intravaginal misoprostol and intracervical Foley catheter alone or in combination for termination of second trimester pregnancy. J Matern Fetal Neonatal Med 28(1):93–96. https://doi.org/10.3109/14767058.2014.905909 CrossRefPubMedPubMedCentralGoogle Scholar
- 8.Hoppe KK, Schiff MA, Peterson SE, Gravett MG (2016) 30 mL Single-versus 80 mL double-balloon catheter for pre-induction cervical ripening: a randomized controlled trial. J Matern Fetal Neonatal Med 29(12):1919–1925. https://doi.org/10.3109/14767058.2015.1067297 CrossRefPubMedPubMedCentralGoogle Scholar
- 9.Pennell CE, Henderson JJ, O’Neill MJ, McChlery S, McCleery S, Doherty DA, Dickinson JE (2009) Induction of labour in nulliparous women with an unfavourable cervix: a randomised controlled trial comparing double and single balloon catheters and PGE2 gel. BJOG 116(11):1443–1452. https://doi.org/10.1111/j.1471-0528.2009.02279.x CrossRefPubMedPubMedCentralGoogle Scholar
- 15.Lajusticia H, Martínez-Domínguez SJ, Pérez-Roncero GR, Chedraui P, Pérez-López FR, Project HOaSAH (2018) Single versus double-balloon catheters for the induction of labor of singleton pregnancies: a meta-analysis of randomized and quasi-randomized controlled trials. Arch Gynecol Obstet 297(5):1089–1100. https://doi.org/10.1007/s00404-018-4713-9 CrossRefPubMedPubMedCentralGoogle Scholar
- 16.Rab MT, Mohammed AB, Zahran KA, Hassan MM, Eldeen AR, Ebrahim EM, Yehia M (2015) Transcervical Foley’s catheter versus Cook balloon for cervical ripening in stillbirth with a scarred uterus: a randomized controlled trial. J Matern Fetal Neonatal Med 28(10):1181–1185. https://doi.org/10.3109/14767058.2014.947576 CrossRefPubMedPubMedCentralGoogle Scholar
- 19.Diederen M, Gommers J, Wilkinson C, Turnbull D, Mol B (2018) Safety of the balloon catheter for cervical ripening in outpatient care: complications during the period from insertion to expulsion of a balloon catheter in the process of labour induction: a systematic review. BJOG 125(9):1086–1095. https://doi.org/10.1111/1471-0528.15047 CrossRefPubMedPubMedCentralGoogle Scholar
- 20.Gommers JSM, Diederen M, Wilkinson C, Turnbull D, Mol BWJ (2017) Risk of maternal, fetal and neonatal complications associated with the use of the transcervical balloon catheter in induction of labour: a systematic review. Eur J Obstet Gynecol Reprod Biol 218:73–84. https://doi.org/10.1016/j.ejogrb.2017.09.014 CrossRefPubMedPubMedCentralGoogle Scholar