Management of prolonged pregnancy by induction with a Foley catheter.

OBJECTIVES

To describe labor outcomes in women with prolonged pregnancy and induction of labor with a Foley catheter, as compared with women with spontaneous onset of labor.

DESIGN

Retrospective study.

SETTING

Helsinki University Hospital.

SAMPLE: 553 women with uncomplicated prolonged pregnancies between January 2011 and January 2012, divided into 303 women (54.8%) with Foley catheter induction and 250 (45.2%) with spontaneous labor.

METHODS

Maternal and neonatal characteristics of women with uncomplicated singleton pregnancy of ≥41(+5) weeks of gestation were analyzed.

MAIN OUTCOME MEASURES: Cesarean delivery rates, maternal and neonatal morbidity.

RESULTS

The cesarean delivery rate was 30.7% (n = 93/303) in women with labor induction and 4.8% (12/250) in women with spontaneous onset of labor (p < 0.001). The cesarean delivery rate was 37.3% (91/244) among nulliparous women with labor induction and 8.7% (11/126) among women with spontaneous labor, a sixfold increased risk (odds ratio 6.2). Among parous women, cesarean section rates were low and not significantly different (3.4% vs. 0.8%, p = 0.2). There were no differences in maternal intrapartum or postpartum infection rates or adverse neonatal outcomes between the groups.

CONCLUSIONS

Foley catheter induction of labor in prolonged pregnancy did not increase maternal or perinatal morbidity compared with spontaneous onset of labor but was associated with a considerably increased cesarean section rate, particularly among nulliparous women.