Pre-induction cervical ripening by Foley's catheter in relative indication of cesarean section.

Introduction: The rate of caesarean section (CS) has continued to rise upward. Many complications could occur during C-section. The balloon catheter, including Foley's single- balloon catheter, appears to be a widely accepted mechanical method and is recommended by the WHO for the normal vaginal induction process. Aim of the work: To evaluate the success rate of pre-induction cervical ripening with Foley's catheter in cases of relative indication for caesarean section and increase rate of vaginal delivery within 24 hours in Tobruk-Libya. Patients, Materials and Methods: Prospective case control study in Gynecology and Obstetrics department at Tobruk Medical Center, Libya from January 2020 to December 2020. The study group include 146 selected cases of relative indications for caesarean section: (10) cases of grand multi (controlled HTN - controlled DM - cardiac cases), (6) cases of multigravida breech, (20) cases of oligohydramnios (AFI-3-4cc) In grand multi, (24) cases of grand multi post-date and (86) cases of previous C/S (PROM, post-date and with medical cardiac disease as DM - HTN). Women scheduled for induction of labor between 37-41 weeks of gestation admitted to maternity with singleton. Results: Most of patient expel within 4-6 hours and bishop score obtained then amniotomy done. Most of them were delivered without augmentation. Few cases need augmentation by 1 unite syntocinon. A few cases failed and did not expel the catheter and shifted to C/S. Very few cases are complicated by chorioamnionitis. Total cases are 146 with 132 (90.4 %) cases delivered normal within 24 – 48 hours while 14 (9.6 %) cases ended by C/S Conclusion: Cervical ballooning by Foley's catheter is a pre-induction safe method, efficient, and offering potential to increase the rate of vaginal deliveries in pregnant women with relative indication for cesarean section.