Induction of labour with Foley's catheter versus vaginal misoprostol in post-date obese primigravidas. A randomized controlled trial

Abstract

he rising incidence of obesity all over the world represents critical health care challenge being doubled over the past 30 years. Around 17.3% of pregnant women are obese. Obesity in pregnancy is associated with an increased risk of miscarriage, prematurity, congenital anomalies, still birth, cesarean section, dysfunctioning labour, post-partum hemorrhage, and wound infection. Women with booking BMI >30 should have an informed discussion antenatally about intrapartum complications associated with a high BMI include slow labour progression, shoulder dystochia, emergency cesarean section, and post-partum hemorrhage. There is a higher risk of cesarean section in obese post date pregnant women undergoing induction of labour (IOL). Therefore, obstetricians should pay more attention to advising pregnant women about optimal weight gain during pregnancy and counseling about the chances of vaginal delivery in cases of IOL. The most common methods of labour induction when the status of cervix is unfavourable involve intravaginal use of misoprostol, transcervical insertion of Foley's catheter, and insertion of prostaglandin gel whereas with a ripe cervix oxytocin may be administrated intravenously. This study aims to compare the effectiveness of intra uterine extra amniotic Foley's catheter filled with 30 ml sterile saline solution to 25 microgram vaginal misoprostol every 4 hours regimen for induction of labour in obese primigravidas presenting with post date pregnancy.