Hyaluronidase versus Foley catheter for cervical ripening in high-risk term and post term pregnancies

Abstract 

Objective

To evaluate the effectiveness and safety of Foley catheter and hyaluronidase for cervical ripening.

Method

Randomized controlled trial where 140 pregnant women, with gestational age ≥37 weeks, indication for labor induction and an unripe cervix, were enrolled, allocated in two groups according to the method of cervical ripening before labor induction. Statistical analysis used Student's t-test, Mann–Whitney, Chi-square test, survival analysis, risk ratios and number needed to treat.

Results

Time of induction, dose of oxytocin and mode of delivery had better results in the Foley catheter group. Comfort with the method was higher in the hyaluronidase group.

Conclusions

Both methods were effective and safe for cervical ripening. The Foley catheter group experienced a shorter period of induction, required a lower dose of oxytocin and had higher vaginal delivery rates, while the women who used hyaluronidase declared greater comfort with the method.

Keywords: Cervical ripening, Foley catheter, Hyaluronidase, Labor induction