A comparative study of induction of preterm vaginal delivery at 20 to 28 weeks gestation in previous one lower segment caesarean section by foley catheter and prostaglandin E2 gel

Background: The aim of the study to assess the maternal outcome and safety of induced preterm vaginal birth after a previous one lower segment caesarean delivery.Methods: In this study, 100 women who had singleton pregnancies with a previous one term lower segment caesarean section, in whom induction of labour was required in between 20 to 28 wks of gestation, were included. Group A (n= 50) were induced by transcervical foley catheter and group B (n= 50) were induced by prostaglandin E2 gel and then progression of labour was monitored. Both groups were compared in terms of induction delivery interval, efficacy and safety.Results: In our study, all women were delivered vaginally and hysterotomy was not required. The mean induction delivery interval in Foley catheter group (20.180±3.3499 hrs) was significantly shorter (p-value <0.001) than PGE2 gel group B (24.050±3.6537 hrs). There was no case of uterine rupture, puerperal pyrexia, postpartum haemorrhage and uterine hyperstimulation.Conclusions: Women with previous lower segment caesarean section in whom premature induction of labour is required for any reason can be done easily, safely and effectively without maternal morbidity. Induction can be done more effectively by using transcervical foley catheter than intracervical prostaglandin E2 gel. It has shorter induction delivery interval and low complication. Hence, I suggest that every woman with previous one lower segment caesarean section who requires premature induction should go for trial of labour before repeating caesarean section