Induction of labor using a foley catheter and extraamniotic corticosteroids

OBJECTIVE: The amniotic membranes contains receptor for glucocortic mis Kossman. Biol Reprod. l W21, which participate in svnthesis of i osiaglandins. Ye examined the lupolhesis thai corticostei oids when administered extra-amnioticalK can enhance ihe labor process and reduce the induction-to-deliven time interval. STUDY DESIGN: A double-blind randomized suidv. Ninety-eight patients, gestational age S(i to 42 weeks, with unfavorable cervix, singleton pregnancx at vertex pi esentalion, inlai l nieml)vanes and medical indications for deliverv were i andomh assigned to receive eitbei 20 mg ot dexamethasone in saline (stud group, n -50). or saline onlv (control group, n = -4H). Treatment was administered extra-anmioiicalK through an intraccnical inflated folev catlietei balloon. The net cil eel of steroids uas assessed using mnltivaiiaie logisti i egression anahsis acljusted for potential conlounders such as parilv and gesialional age. Imhiction-io-delivcrv inieral was catalegoried as short (belou the nieou.in) nr long (above the median). RESULTS: Fom-iuo (H4.0'V ) patients in the study group, and 40 (S.'V.'Vy ) of the patients in ihr i ontrol gioup entered the active phase of labor. The lime interval between induction ol labor to acthe phase was Mtnnfi<anlK shortet in the slufh group (7.S ±:>. 1 h) compaied to the t ontrol gioup (9.9 ±.O h. p -. 0.0:>i. The time interval between induction ol labor and deliven uas significantK shorter in ihe stiuh group (11. 1. -S.O ID vs. the (ontrol gioup (1-4.> 1 -4.S h. p < 0.01). Those noi receiving sici oids had ,VJ times higher risk to hae long inienal (95 CI 1.1-9.5). No significant difference was detected betueen the two groups with respect to (esarean delier rate, 01 in ihe incidence of maternal or fetal complications. CONCLUSIONS: India tion ol labor using intra-cenical loley latheter balloon and extia-amtiiotic coiiicostei'oids significant reduces both the indui lion-to-active pliase and ihe induction-to-delivery time intervals.