TITLE:
Pre-Induction Cervical Ripening Using a Transcervical Foley Catheter Combined with ISMN Vaginal Tablets for Vaginal Birth after Previous Caesarean Section (VBAC)—A Comparative Study
AUTHORS:
D. Liyanapatabandi, J. Karunasinghe, M. H. Ziard, R. Prathapan, S. I. Wickramasinghe
KEYWORDS:
Isosorbide Mononitrate (MeSH), Vaginal Birth After a Cesarean (MeSH), In-duced Labor (MeSH)
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.11 No.11,
November
18,
2021
ABSTRACT: Objective: To compare the effectiveness, safety and client
acceptability of concurrent application of transcervical Foley catheter with
vaginal ISMN-sustained release (SR) 60 mg tablet versus transcervical Foley
catheter alone for pre-induction cervical ripening in women who are undergoing
Vaginal birth after C-section (VBAC). Method: A prospective single blind
randomized control study was carried out including 110 pregnant women who had
unfavorable cervix (MBS less than 6) at 40 weeks and 3 days of gestation. The
two groups received either the trans-cervical foley catheter with a vaginal
ISMN 60 mg sustained release (SR) tablet on 40 weeks and 3 days (Treatment arm
1, n = 57), or trans-cervical Foley alone on 40 weeks and 3 days (Treatment arm
2, n = 53). Results: At 40 weeks + 3 days gestation, the mean
age, mean parity and the mean modified Bishop Score (MBS) were comparable among
the two treatment groups. Majority (n = 98, 89.1%) remained without
spontaneously establishing labour at 24 hours of intervention. The difference
in mean MBS at 40 weeks + 4 days (24-hours following the intervention) in the
two groups was statistically not significant (P > 0.05). The group who
received concurrent ISMN vaginal tablets achieved a higher number of successful
VBACs (n = 33, 62.3%) over the group who received the Foley catheter only
method (n = 29, 50.9%), however, not statistically significant (P > 0.05). Conclusions: The
concurrent use of vaginal ISMN tablets (60 mg SR)
with a transcervical Foley catheter failed to show higher effectiveness
compared to a transcervical Foley catheter alone as an induction method.