International Journal of Clinical Obstetrics and Gynaecology

Background: Induction of labor (IOL) constitutes nearly one-fifth of global deliveries and is highly dependent on cervical favorability. Achieving optimal cervical ripening remains a critical determinant of successful vaginal delivery. Among various methods, the intracervical Foley’s catheter and prostaglandin E? (PGE?) gel are widely utilized, yet comparative evidence regarding their efficacy and safety remains inconclusive.

Objective: This study aimed to evaluate and compare the effectiveness and safety of intracervical Foley’s catheter and PGE? gel for pre-induction cervical ripening in term primigravid women with unfavorable cervices.

Methods: In this prospective, randomized comparative study, 100 term primigravidae were allocated equally into two groups: Group A (Foley’s catheter) and Group B (PGE? gel). Primary outcome was the change in Bishop score after six hours. Secondary outcomes included induction-to-delivery interval, mode of delivery, need for augmentation, and maternal and neonatal outcomes. Statistical analyses were performed using Student’s t-test and chi-square test, with p<0.05 considered significant.

Results: The mean improvement in Bishop score was significantly higher in the PGE? group (3.04±0.06) compared to the Foley group (2.20±0.47; p<0.001). The induction-to-delivery interval was shorter with PGE? (10.25±5.04 h vs. 12.96±3.32 h; p<0.05). Spontaneous vaginal delivery occurred in 76% of the PGE? group versus 56% of the Foley group. Neonatal outcomes were comparable, though NICU admissions were lower with PGE? (12% vs. 26%).