# Effectiveness of Intracervical Foley Catheter for Induction of Labor in Women With Singleton Term Pregnancy and Previous Lower Segment Cesarean Section: A Pilot Study

## TL;DR

This pilot study shows that using an intracervical Foley catheter to induce labor is effective and safe for women with a previous cesarean section, increasing chances of vaginal birth.

## Contribution

The study provides new evidence on the effectiveness of a mechanical induction method for women with a prior cesarean section.

## Key findings

- 65.62% of women achieved vaginal birth after cesarean (VBAC) using the Foley catheter.
- Modified Bishop score improved significantly after induction (p<0.0001).
- VBAC success was higher in women with prior VBAC history (84.6%) than in those without (52.6%).

## Abstract

Introduction and aim: Current clinical practice advocates and supports a trial of labor after one previous lower segment cesarean section (LSCS) if the pregnant woman wishes to have a vaginal delivery. Induction of labor with pharmacological agents can pose a risk of uterine rupture in women with previous LSCS. Induction with mechanical methods is a safe alternative. However, the data regarding its effectiveness is limited. The present study aimed to assess the effectiveness of intracervical Foley catheter for induction of labor in women with singleton term pregnancy and one previous LSCS.

Materials and methods: This was a cross-sectional retrospective pilot study conducted at the Department of Obstetrics and Gynecology, Nizwa Hospital, Ministry of Health, in Nizwa, Oman. The data of women who fulfilled the eligibility criteria was collected from the hospital's electronic medical records system "Al-Shifa" from October 1, 2023, to March 31, 2024. The change in modified Bishop score, oxytocin requirement, induction delivery interval, mode of delivery, maternal complications, and neonatal outcome were observed. Data analysis was done using the R software (R Foundation for Statistical Computing, Vienna, Austria (https://www.R-project.org/)).

Results: Out of the 64 women who underwent induction of labor, 42 (65.62%) had a vaginal birth after cesarean section (VBAC). There was a statistically significant improvement in the modified Bishop score (p<0.0001) after induction of labor. The VBAC success rate was 84.6% among those with previous VBAC as compared to 52.6% for those without previous VBAC. No significant maternal or fetal complications were observed.

Conclusion: Induction of labor with intracervical Foley catheter serves as an effective method for improving the modified Bishop score in women with previous LSCS and thus increases the chance of a successful VBAC.