Ripening of cervix for induction of labour by hydrostatic sweeping of membrane versus Foley's catheter ballooning alone.

OBJECTIVE: To determine the effectiveness and safety of hydrostatic membrane sweeping versus Foley's catheter ballooning alone in unripe cervix for induction of labour.

DESIGN: Quasi-experimental study.

PLACE AND DURATION OF STUDY: Labour room, department of Obstetrics and Gynaecology, Unit - II, Nishtar Medical College and Hospital, Multan, from 2003 to 2004.

PATIENTS AND METHODS: Fifty medically fit women admitted for normal delivery requiring induction of labour with singleton live pregnancy, Bishop score <6, aged 20-35 years, gestational age > or = 37 weeks and vertex presentation were randomized into two groups for cervical ripening by Foley's catheter ballooning method (group-A) and by hydrostatic membrane sweeping (group-B). Oxytocin infusion was started after catheter expulsion or at 18 hours and amniotomy was carried out once cervix opened to 2 cm or more. Outcome was measured by Bishop score, insertion to delivery interval, mode of delivery and rate of cesarean section.

RESULTS: Mean Bishop score was 7.08 +/- 1.97 in group A and 8.08 + 2.66 in group B (p<0.06). Bishop score > 8 achieved in 60% (15/25) of the patients in group A and 72% (18/25) of the patients in group B. Insertion to delivery interval was 22.30+/-4.03 hours (range 17.25 - 32 hours) in group A and 20.53 + 3.71 hours (range 15 - 29 hours) in group B (p<0.05). Rate of cesarean section was 28% (7/25) in group A and 24% (6/25) in group B.

CONCLUSION: Both Foley's catheter ballooning and hydrostatic membrane sweeping were inexpensive and safe, but hydrostatic membrane sweeping was more effective for better improvement in Bishop score and short insertion to delivery interval.