Amer J Perinatol 2017; 34(11): 1108-1114
DOI: 10.1055/s-0037-1603994
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

A Randomized Trial of Foley Balloon Induction of Labor Trial in Multiparas (FIAT-M)

Katherine A. Connolly1, Katherine S. Kohari2, Stephanie H. Factor1, 3, Patricia Rekawek1, Meredith R. Miller1, Brooke S. Smilen1, Joanne L. Stone1, Angela T. Bianco1
  • 1Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York
  • 2Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut
  • 3Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
Further Information

Publication History

16 May 2017

25 May 2017

Publication Date:
26 June 2017 (eFirst)

Abstract

Background The optimal method of labor induction is not known. It is important to determine the safest and efficient method to minimize the length of labor, hospital stay, cost, and adverse outcomes.

Objective This study aims to determine if induction of labor with simultaneous use of oxytocin and Foley balloon versus the sequential use of Foley balloon followed by oxytocin decreases the time to delivery in multiparous women.

Study Design We conducted a randomized controlled trial of multiparous women who presented for induction of labor at Mount Sinai from December 2013 to April 2016. Patients were admitted for induction with indications determined by their provider. Women with a nonanomalous, singleton fetus ≥ 24 weeks in vertex presentation with intact membranes were offered participation. Exclusion criteria included the history of uterine surgery, unexplained vaginal bleeding, latex allergy, or contraindication to vaginal delivery. Participants were randomized to either simultaneous (oxytocin and Foley balloon) or sequential (oxytocin after the expulsion of Foley balloon) induction group. The primary outcome was the time from induction to delivery. Secondary outcomes included mode of delivery, estimated blood loss (EBL), postpartum hemorrhage (PPH), chorioamnionitis, and composite neonatal outcome. Maternal and neonatal outcomes were collected via chart review. Analyses were done on an intention-to-treat basis.

Results A total of 142 patients were enrolled; 75 in the simultaneous and 67 in the sequential group. There were no differences in baseline characteristics in the two groups. There was no difference in median time to delivery between groups (10.7 vs. 10.6 hours, p = 0.44). There was no difference in the rate of cesarean delivery, EBL, PPH, chorioamnionitis, or composite neonatal outcome.

Conclusion Simultaneous use of oxytocin and Foley balloon for induction of labor does not decrease time to delivery in multiparas.

Clinical Trial Registration

This trial is registered at clinicaltrials.gov (NCT02098421).


Note

This abstract was presented at the 37th Annual Pregnancy Meeting of the Society for Maternal Fetal Medicine; January 27, 2017 in Las Vegas, Nevada (abstract 746).


Funding

None.