Is transcervical Foley catheter actually slower than prostaglandins in ripening the cervix? A randomized study

OBJECTIVE: The purpose of this study was to determine whether the maximum time for cervical ripening (from 24-12 hours) would influence the efficacy of a transcervical Foley catheter and to compare efficacy to that of a prostaglandin E-2 vaginal insert. STUDY DESIGN: Three hundred ninety-seven women were assigned randomly to (1) Foley catheter left in place for a maximum of 24 hours, (2) Foley catheter left in place for a maximum of 12 hours, or (3) prostaglandin E-2 controlled-release vaginal insert. Primary outcome was vaginal delivery within 24 hours. RESULTS: There were no differences in vaginal delivery rates. The proportion of women who achieved vaginal delivery in 24 hours was lower in the 24-hour Foley catheter group than in the other 2 groups (24-hour Foley catheter, 21.0%; 12-hour Foley catheter, 59.8%; vaginal prostaglandin E-2, 48.5%; P < .0001). CONCLUSION: Cutting the ripening time with a Foley catheter by one-half increases the proportion of women who deliver vaginally within 24 hours and yields efficacy similar to that of prostaglandin E-2 vaginal insert.