Abstract
Objective Evaluate the association between cervical examination after ripening with Foley catheter
and labor induction outcomes.
Materials and Methods In this retrospective cohort, nulliparous women with singleton, viable gestation
undergoing cervical ripening with Foley catheter were compared based on cervical status
after catheter removal or expulsion: favorable (modified Bishop score ≥ 5) or unfavorable
(score < 5). Bivariable and multivariable analyses were performed to determine whether
cervical examination postripening was associated with time to delivery and chance
of vaginal delivery.
Results A total of 774 women were eligible. Women with favorable examination postripening
had lower body mass index (BMI) and more favorable admission cervical examination.
The frequency of vaginal delivery was higher in women with favorable cervical examination
postripening (57.9% versus 46.8%, p < 0.01). Median durations from Foley removal or expulsion to complete dilation (8.6 h
versus 11.5 h) and vaginal delivery (10.4 h versus 13.2 h) were shorter for women
with favorable cervical examination postripening (p < 0.001). In multivariable analysis, favorable examination postripening remained
associated with vaginal delivery (adjusted odds ratio 1.39, 95% confidence interval
1.04–1.87), and time to vaginal delivery (adjusted hazard ratio 1.39, 95% confidence
interval 1.13–1.70).
Conclusion A favorable modified Bishop score after cervical ripening with Foley balloon catheter
is associated with higher chance of vaginal delivery and shorter labor duration.
Keywords
Bishop score - Foley balloon catheter - labor induction - nulliparous
