Safety and Efficacy of High-Volume (60 mL) Foley Catheter for Induction of Labour: A Prospective Descriptive Cohort Study from Swabi, Pakistan
DOI:
https://doi.org/10.52206/jsmc.2026.16.1.1383Abstract
Background: Mechanical methods of cervical ripening, particularly the Foley catheter, are widely used for labour induction due to their safety, low cost, and reduced risk of uterine hyperstimulation compared with pharmacological agents. In low-resource settings, high-volume Foley catheter use may offer additional advantages; however, local evidence from Pakistan remains limited.
Objective: To evaluate the safety and efficacy of a high-volume (60 mL) Foley catheter for cervical ripening and induction of labour, with a primary focus on the rate of vaginal delivery within 24 hours.
Methodology: This prospective descriptive cohort study was conducted at Bacha Khan Medical Complex, Swabi, from June to December 2024. A total of 86 term pregnant women with singleton cephalic pregnancies and unfavorable cervices underwent labour induction using a 20 Fr Foley catheter inflated with 60 mL of normal saline. Primary and secondary outcomes included induction-to-labour interval, induction-to-delivery interval, mode of delivery, and maternal and neonatal complications.
Results: The mean maternal age was 26.8 ± 5.3 years, and the mean pre-induction Bishop score was 4.0 ± 0.82. The median induction-to-labour interval was 250.5 minutes (IQR 198–416.2), while the median induction-to-delivery interval was 682.5 minutes (IQR 550.5–870). Vaginal delivery within 24 hours was achieved in 82.5% of participants, including 75.5% spontaneous and 6.9% instrumental vaginal deliveries. Cesarean section was required in 17.4% of cases. Maternal and neonatal complications were minimal, with no cases of uterine rupture, hyperstimulation, or severe morbidity.
Conclusion: High-volume (60 mL) Foley catheter induction is a safe and effective method for cervical ripening, achieving high rates of vaginal delivery within 24 hours with minimal maternal and neonatal complications. Larger multicenter randomized trials are recommended to further validate these findings.
Keywords: Cervical Ripening, Foley Balloon Catheter, Labour Induction.
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