COMPARATIVE STUDY OF INTRACERVICAL CATHETER AND TABLET PROSTAGLANDIN FOR INDUCTION OF LABOUR IN POSTDATED PREGNANCY

Abstract

Background: Induction of labour is an essential obstetric intervention for postdated pregnancies (?41 weeks), with higher perinatal risks. There are several methods of induction, including pharmacological agents such as prostaglandins and mechanical devices such as intracervical catheters. Their relative efficacy is controversial.

Methods: This randomized controlled trial was undertaken at Qazi Hussain Ahmad Medical Complex, Nowshera, between March 25 and September 25, 2023, among 76 postdated pregnant women. Randomization was done to Group A (n=38), who were given an intracervical Foley catheter, and Group B (n=38), who were given 3 mg vaginal dinoprostone. The successful labour induction within 24 hours was the primary outcome. Data was analyzed with SPSS.

Results: Successful labour induction was much greater in the prostaglandin group (68.4%) than in the catheter group (42.1%) (p=0.021). Prostaglandins allowed earlier cervical ripening and a shorter induction-delivery interval. They did, however, carry a greater risk of uterine hyperstimulation, for which vigilance and monitoring are necessary. Both procedures were associated with good maternal and neonatal outcomes.

Conclusion: Prostaglandins were more effective in the induction of labour than intracervical catheters. Nevertheless, mechanical techniques are still an acceptable alternative, especially in women with contraindications to pharmacologic induction. The method should be tailored to the patient, taking efficacy as well as safety into consideration. Larger sample size studies should be conducted to look at long-term maternal and neonatal outcomes.