FOLEY CATHETER CERVICAL RIPENING WITH EXTRA- AMNIOTIC INFUSION OF SALINE OR CORTICOSTEROIDS: A DOUBLE-BLIND, RANDOMIZED CONTROLLED STUDY

Abstract- Induction of labor is one of the most common procedures during pregnancy. Various methods for cervical ripening and labor induction have been described in the obstetrics literature; but the role of corticosteroids in the process of labor is not entirely understood. This study challenged the possible role of corticosteroids in induction of labor by extra-amniotic injection through an inflated intracervical Foley balloon catheter. This randomized trial was conducted on 44 women with a single pregnancy, intact membranes, and an unfavorable cervix. They were randomly assigned to receive either 20 mg of dexamethasone in saline solution (study group, n=22) or saline solution only (control group, n=22) administered extra-amniotically through an intracervical inflated Foley balloon catheter. Eighteen (81.8%) patients in the study group and 20 (90.9%) in the control group entered the active phase of labor and were delivered vaginally. The mean time intervals between induction of labor to the active phase and between induction of labor to delivery were significantly shorter in the study group compared with those of the control group (3.3±2.1 hours vs. 9±4.7 hours, P<0.01, 5.7±3.4 hours vs. 6.9±4.7 hours, P<0.01, respectively). There was no maternal or fetal complication in study or control group. The intracervical Foley balloon catheter with extra-amniotic corticosteroids was more efficient in reducing the induction-to-delivery interval for termination of midtrimester pregnancies than the same Foley catheter with saline solution only. Cervical ripening with extra-amniotic corticosteroids possesses the advantages of simplicity, low cost, and lack of systemic or serious side effects