Labor Induction in Postdate Primigravida Women with Poor Bishop Score: Comparison of Vaginal Prostein and Intracervical Foley Catheter

Qurat Ul Ain Zaman; Tayaba Ayub; Ayesha Rehman; Zeenat Afridi; Palwasha Jamal; Nayab Rawel

doi:10.54112/bcsrj.v6i6.2359

Authors

Qurat Ul Ain Zaman Department of Obstetrics & Gynaecology, Khyber Teaching Hospital, Peshawar, Pakistan
Tayaba Ayub Department of Obstetrics & Gynaecology, Khyber Teaching Hospital, Peshawar, Pakistan
Ayesha Rehman Department of Obstetrics & Gynaecology, Khyber Teaching Hospital, Peshawar, Pakistan
Zeenat Afridi Department of Obstetrics & Gynaecology, Khyber Teaching Hospital, Peshawar, Pakistan
Palwasha Jamal Department of Obstetrics & Gynaecology, Khyber Teaching Hospital, Peshawar, Pakistan
Nayab Rawel Department of Obstetrics & Gynaecology, Khyber Teaching Hospital, Peshawar, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v6i6.2359

Keywords:

Labour Induction, Postdate Pregnancy, Primigravida, Foley Catheter, Prostein, Bishop Score, Cervical Ripening

Abstract

Induction of labor is a common obstetric intervention in postdate pregnancies, particularly among primigravida women with an unfavorable cervix. Pharmacological agents such as vaginal prostaglandin E2 (Prostein) and mechanical methods such as the intracervical Foley catheter are widely used for cervical ripening and labor induction. Comparing their effectiveness in reducing induction-to-delivery time may help optimize maternal and neonatal outcomes. Objective: To compare the mean induction-to-delivery time between vaginal Prostein and intracervical Foley catheter for labor induction in postdate primigravida women with a poor Bishop score. Methods: This comparative study was conducted on 110 primigravid women with postdate pregnancy and an unfavorable cervix (poor Bishop score) from 12 December 2024 to 12 April 2025 in the Department of Obstetrics & Gynecology, Khyber Teaching Hospital, Peshawar. Participants were randomly allocated into two equal groups. Group A received vaginal Prostein (prostaglandin E2, 3 mg) placed in the posterior vaginal fornix and repeated after 8 hours if required, with a maximum of three doses. Group B underwent intracervical insertion of a 22F Foley catheter with the balloon inflated using 80 mL of distilled water. The primary outcome was induction-to-delivery time, defined as the interval from initiation of labor induction to delivery. Data were analyzed using SPSS version 25. Continuous variables were compared using the independent t-test, with a p-value <0.05 considered statistically significant. Results: A total of 110 women were included, with 55 per group. The mean age was 28.98 ± 6.49 years in the Prostein group and 29.13 ± 6.76 years in the Foley catheter group. The mean induction-to-delivery time was significantly shorter in the intracervical Foley catheter group (26.16 ± 7.94 hours) compared with the vaginal Prostein group (33.04 ± 11.29 hours) (p = 0.001). Conclusion: Intracervical Foley catheter significantly reduced the induction-to-delivery interval compared with vaginal Prostein in postdate primigravida women with a poor Bishop score. These findings suggest that the Foley catheter is an effective mechanical method for labor induction in women with an unfavorable cervix.

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