Foley's Catheter Balloon with Sequential Misoprostol for Induction of Mid Trimester Abortions- An Observational Study

Background: The utilization of the Foley catheter method has demonstrated a faster abortion process compared to using misoprostol alone, reducing the time from induction to delivery. However, concerns exist regarding the infection risk associated with the Foley catheter technique, particularly in cases of prolonged prelabour rupture of membranes. Objectives: To evaluate the safety and effectiveness of combining the Foley catheter bulb with sequential misoprostol for the induction of second-trimester abortions. Methods: We conducted a prospective observational study on women seeking pregnancy termination between 13-28 weeks of gestation. Twenty participants underwent foley catheter followed by induction with misoprostol. The primary focus was on the duration from induction to abortion. Secondary outcomes included rates of complete abortion, need for surgical placenta removal, and occurrence of complications. Results: Our study revealed that 70% of participants were in the 20-30 years age group, with 45% being primiparous. Approximately 25% had a history of abortions for various reasons, and 55% had previous childbirth experiences, including 20% who had cesarean sections and 10% who had vaginal deliveries. The mean durations from induction to bulb expulsion, bulb expulsion to abortus expulsion, and induction to product expulsion were 8.75 hrs, 6.4 hrs, and 14.05 hrs, respectively. The rate of complete abortion was 80%, with 20% requiring surgical placenta removal. Some participants encountered minor complications like fever (30%), severe pain (VAS scale ≥ 5) (85%), and the need for blood transfusions (10%). No major complications were reported. Conclusion: The combined use of Foley catheter balloon and misoprostol sequentially is a safe, effective, and well-tolerated approach for terminating pregnancies in the second trimester, without a significant increase in adverse effects or maternal risks