Cervical ripening with Foley catheter for induction of labor after cesarean section: a cohort study.

OBJECTIVE

To evaluate spontaneous vaginal delivery and complication rates after induction of labor with a transcervical Foley catheter in women with a previous cesarean delivery.

DESIGN

Retrospective cohort study.

SETTING

Secondary teaching hospital in the second largest city of the Netherlands.

POPULATION: Women with a history of cesarean delivery (n = 208), undergoing induction of labor with a Foley catheter in a subsequent pregnancy.

MATERIAL AND

METHODS

The women who had induction of labor with a transcervical Foley catheter in the Ikazia Hospital, Rotterdam, between January 2003 and January 2012, were identified in a computerized database. Patient's records were checked for accuracy.

MAIN OUTCOME MEASURES: Vaginal delivery rate, cesarean section rate, uterine rupture and maternal and neonatal (infectious) morbidity.

RESULTS

Of the women 60% had a spontaneous vaginal delivery and 11% were delivered by vacuum extraction. Uterine rupture occurred in one woman. Postpartum hemorrhage was the most common maternal complication (12%). Maternal intrapartum and postpartum infections occurred in 5% and 1%. Proven neonatal infection was found in 3% of the cases. Two perinatal deaths occurred (1%), of which one was related to uterine rupture.

CONCLUSION

Induction of labor with a transcervical Foley catheter is an effective method to achieve vaginal delivery in women with a previous cesarean delivery. There is a low risk of uterine rupture and maternal and neonatal (infectious) morbidity in this cohort.