الفهرس 
Introduction
The CervixOnly 14 pages are availabe for public view
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Abstract
Cervical status is one of the most important factors
for predicting successful induction of labor. Women who
require labor induction often present with unfavorable
cervix, the induction rate is around 10-20%. Pre induction
cervical ripening is often done to increase the likelihood of
successful labor induction. Cervical ripening or
preparedness for induction should be assessed before a
regimen is selected. Assessment is accomplished by
calculation of Bishop’s score.
The common clinical practice nowadays in pregnant
women undergoing pre-induction cervical ripening by the
use of prostaglandins E2 or by mechanical methods such as
an interacervical balloon catheter like the Foley’s catheter
30ml or 60ml).
The aim of this study was to compare the efficacy of
transcervical Foley’s catheter balloon versus prostaglandins
E2 tablet(s) as pre-induction cervical ripening agent.
The present study was a prospective randomized
clinical trial. Ninety pregnant women admitted for labor
induction, which was conducted at the labor ward of Ain
Shams Maternity Hospital, during the period from June
2013 to August 2014 after obtained an informed consent.
The women in this study subdivided into groups
(prostaglandin E2 group) which used of 3 mg dinoprostone
inserted vaginally every six hours, for a maximum dose of
(2 doses), (Foley’s catheter 30ml group) assigned for the
use of the transcervical Foley’s catheter with 30 ml balloon
capacity, which was inserted for a maximum period of 12
hours, till its spontaneous expulsion, or till a ripe cervix
was reached (Bishop’s score≥5) and (Foley’s catheter 60ml
group) as Foley’s catheter 30ml but 60 ml balloon
capacity.
All pregnant women who met the inclusion criteria
were submitted to full history taking, general, abdominal
and vaginal examination to determine the initial Bishop’s
score,. Record of the time of insertion of each treatment
modality was taken, and time of subsequent doses or
adjustment together with information about women’s
progress or events happened during the labor follow up.
Oxytocin was used (and recorded in the special forms) in
three groups when indicated, with respect that it was not
started until 6 hours after the last dose in those pregnant
women who received intravaginal dinoprostone. Records
were kept of occurrence of any complications, route of
delivery and time, and the neonatal outcomes including
Apgar scores.
Statistical analysis of the obtained results showed the
three groups as regard mean age, parity, estimated
gestational age and the initial Bishop’s scores (preripening).
The indications for labor induction varied
between past data, hypertensive disorders, oligohydramnios
and gestational diabetes were no statistically significantly.
Preinduction Bishop’s scores were no statistically
significantly between women of (Foley’s catheter 60ml
group or Foley’s catheter 30ml group compared to
dinoprostone (prostaglandin E2 group). On the other hand
three treatment modalities (each separately) showed
statistical significant improvement in the pre induction
Bishop’s scores compared to the initial ones.
Foley’s catheter 60ml had significantly reduced the
time of cervical ripening and the total time from start
ripening till delivery when compared to prostaglandin E2
group or Foley’s catheter 30ml group.
Three treatment modalities (prostaglandin E2 group,
Foley’s catheter 30ml Foley’s catheter 60ml) were no
statistically significantly on the route of delivery of the
women ,neonatal outcomes, Apgar scores and the need for
oxygen supplementation during post delivery neonatal
resuscitation. Three treatment modalities (prostaglandin E2 group, Foley’s catheter 30ml or Foley’s catheter 60ml)
were effective in achieving pre-induction cervical ripening,
but the latter had achieved shorter time of achieving the
desired effects.