Concurrent Use of Intracervical Foley\'s Catheter with Intravenous Oxytocin Compared with Prostaglandin Analogues for Induction of Labor: A Prospective Observational Study

Aims and background: Induction of labor (IOL) is one of the most widely performed procedures in obstetric practice, with a rising incidence in recent times.The methods of labor induction may be mechanical, pharmacological, surgical, or a combination of these.It is important to assess these methods and determine the safest and most effective one to ensure the best possible maternal and perinatal outcome.Primaryto compare the induction-to-delivery time in labor induction with concurrent intracervical Foley's catheter plus intravenous oxytocin and prostaglandins [prostaglandin E2 (PGE2)/prostaglandin E1 (PGE1)] alone.Secondary-to compare the proportion of patients that needed further doses of induction with prostaglandin analogues (PGE2/PGE1) or augmentation with oxytocin, based on Bishop's score (if < 8) after 24 hours, in each of the two groups.To compare the incidence of tachysystole, fetal distress, intrapartum febrile illness, and cesarean section with concurrent intracervical Foley's catheter plus intravenous oxytocin and prostaglandins (PGE2/PGE1) alone.Materials and methods: This was a prospective observational study conducted in the Department of Obstetrics and Gynaecology in a Tertiary Care hospital, from August 2022 to June 2024, in pregnant women at term.The study population included 116 participants across two groups-A and B. A total of 58 participants in group A were induced with prostaglandin analogues alone.A total of 58 participants in group B were induced with a concurrent intracervical Foley's catheter and intravenous oxytocin.Results: The mean induction-to-delivery interval in group A was 32.0 20.7 hours, compared to 36.2 24.4 hours in group B; the difference between them was not statistically significant.The number of further doses of induction required in both groups was similar, with no significant difference between the two.There was no significant difference in maternal or perinatal complications between the two groups. Conclusion:The concurrent use of an intracervical Foley's catheter balloon and intravenous oxytocin infusion is a safe and effective method of labor induction and is a reliable alternative to the use of prostaglandin analogues.The use of concurrent Foley's catheter + oxytocin was associated with better initial improvement in Bishop score, as compared to prostaglandin analogues alone, and thus can be considered an effective cervical ripening method.A similar number of additional doses of induction were required in both groups.Both methods are associated with similar rates of cesarean delivery.Both methods have no significant difference in associated maternal or perinatal complications.Clinical significance: The concurrent use of an intracervical Foley's catheter balloon and intravenous oxytocin infusion is a safe and effective method of labor induction and is a reliable alternative to the use of prostaglandin analogues.It is associated with better initial improvement in Bishop score, as compared to prostaglandin analogues alone, and thus can be considered an effective cervical ripening method.