Bindu Kulakandathil Mani 1 , Cicily Thadathiplackal Joseph 2 , Latha Kalarickal Govindanachari 3
BACKGROUND The favourability of cervix is of fundamental importance for successful induction of labour. Unfavourable cervix should be ripened before induction is started. The various methods available for cervical ripening include both pharmacological and nonpharmacological. Pharmacological methods though effective are associated with significant lethal untoward effect on mother, foetus or newborn and expensive also. The aim of this study is to evaluate the effectiveness and safety of Foley's catheter with extra amniotic saline infusion (EASI) on cervical ripening and induction of labour. MATERIALS AND METHODS This prospective observational study was conducted in the Department of Obstetrics and Gynaecology, Government Medical College, Kottayam, from January 2012 to October 2012. Total of 201 antenatal women who satisfied the inclusion and exclusion criteria were included in this study. The main outcome variables were the number of subjects with favourable Bishop's score, mode of delivery, induction delivery interval, newborn Apgar score and incidence of intra-amniotic infection or postpartum endomyometritis. RESULTS The mean pretreatment Bishop's score was 2.125±0.609, 75.6% were having Bishop's score 2. There was significant improvement in Bishop’s score after EASI. 156 patients achieved Bishop's score >6 after EASI. Maximum patients (76.6%) achieved vaginal delivery. The caesarean rate was 18.4%. The mean induction delivery interval was 11.02 hours. 68.2% women required oxytocin induction or augmentation. The mean Apgar score at 5 minutes was 8.94 with 99% babies having Apgar score >7 at 5 minutes and 12.34% NICU admissions. No maternal complications were observed. CONCLUSION EASI is an effective method for cervical ripening and EASI ripening resulted in successful induction with shorter induction delivery interval, low caesarean section rate with no maternal, foetal or neonatal complication. EASI is simple, reversible, inexpensive, easily available and no refrigeration is needed. With the use of prophylactic antibiotics, the safety can be increased.
