Parity And Foley Catheter Using Tension Or No Tension: A Randomized Controlled Trial

INTRODUCTION: A secondary analysis of a randomized controlled trial was performed to determine the effects of parity on the use of a Foley transcervical balloon catheter for cervical ripening and the effects of tension on each group. METHODS: 73 nulliparous and 67 multiparous women underwent cervical ripening with a Bishop score ≤ 6. Tension was created by securing the catheter to the thigh and replacing tension in 30 minute increments. Major outcomes included time from insertion to delivery, time from insertion to catheter expulsion, and mode of delivery. A p value of < 0.05 denoted statistical significance. RESULTS: Nulliparous patients had a higher rate of Cesarean delivery (CD) (39.7% vs 22.4%, p = 0.027). They had a longer median time to delivery (17.5 vs 14.6 hours, p=0.054). Applied tension did not shorten times from catheter insertion to delivery or to expulsion. A significantly shorter median time from catheter insertion to expulsion was found in the tension group in multiparous women (2.88 vs 4.61 hours, p= 0.003). Multiparous women in the no tension group had a higher rate of CD than women in the tension group (31.6 % vs 10.3%, p= 0.039). CONCLUSION: Within multiparous patients, applied tension decreased the time to expulsion of the catheter, whereas no tension may increase the likelihood of CD. Further studies to evaluate these findings are needed. As expected, nulliparity increased the risk of CD and there was a trend towards longer delivery times compared to multiparous patients.