Duration of Foley Catheter Cervical Ripening as A Predictor of Total Length of Labor

Abstract

Caroline Lau, MD*, Dr. Jennifer Elia, PH and Holly Olson, MD

Objective: To determine whether there is a difference in time to delivery following Foley catheter expulsion when comparing a shorter duration of cervical ripening to a longer duration of cervical ripening among nulliparous patients with intact membranes and unfavorable cervix.

Methods: We conducted a retrospective chart review of all term, nulliparous patients with intact membranes and an unfavorable Bishop Score admitted for labor induction who underwent cervical ripening with a Foley catheter and Misoprostol. Our primary outcome was time to delivery following Foley catheter expulsion. Duration of Foley catheter cervical ripening was stratified into 2 groups depending on the time that the Foley catheter (FB) remained in place: Group 1 (“Fast FB”): ≤4 hours and Group 2 (“Slow FB”): >4 hours.

Results: A total of 175 patients met inclusion criteria. Ninety-one patients were stratified to the “Fast FB” group and 84 patients were stratified to the “Slow FB” group. The mean time to delivery following Foley catheter expulsion was not significantly different between groups (22.84 vs 23.29 hours; P=0.77). Among the 68 patients in the “Fast FB” group and the 55 patients in the “Slow FB” group who achieved vaginal delivery, the mean time to delivery was also not significantly different (20.45 vs 21.37 hours; P=0.68).

Conclusion: Among nulliparous patients with an unfavorable Bishop Score, there is no difference in time to delivery following Foley catheter expulsion. Therefore, efforts to shorten the total duration of labor should focus on expediting the duration of Foley catheter cervical ripening.

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