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Mechanical method of induction of labor in high-risk pregnant women with previous cesarean section

PURPOSE:

To describe the maternal and fetal outcomes with the use of the Foley catheter for induction of labor in high-risk pregnant women with previous caesarean section.

METHODS:

An interventive and descriptive study was conducted from November 2013 to June 2014. A total of 39 pregnant women at term, with a live fetus, cephalic presentation, estimated fetal weight <4,000 g, with previous cesarean section, medical indications for induction of labor, Bishop score ≤6 and amniotic fluid index >5 cm were included. A number 16F Foley catheter was introduced for a maximum of 24 hours, and was considered to be satisfactory when the patient began labor within 24 hours.

RESULTS:

Labor was successfully induced in 79.5% of pregnant women. Nine women achieved vaginal delivery (23.1%), with a frequency of 18% of vaginal births occurring within 24 hours. The main indications for the induction of labor were hypertensive disorders (75%). The mean interval between the placement of the Foley catheter and the beginning of labor and delivery were 8.7±7.1 and 14.7±9.8 hours, respectively. Meconium-stained amniotic fluid was observed in two patients; and an Apgar score <7 in the first minute was detected in 5 newborns (12.8%).

CONCLUSIONS:

The Foley catheter is an alternative for the induction of labor in women with previous caesarean section, despite the low vaginal delivery rate.

Labor, induced/methods; Cesarean section; Vaginal birth after cesarean; Parturition


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