Six vs. Twelve hours of Foley catheter placement

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Time to delivery with a cook catheter and oxytocin was significantly shorter with planned removal at 6 hours rather than 12, according to the results of a randomized controlled trial presented at SMFM’s 2021 Virtual Annual Meeting.

The trial included 178 women aged 18 to 50 years with vertex singletons who were undergoing induction of labor with a Bishop score less than 6 and dilation less than 2 cm. After randomizing to planned catheter removal at 6 and 12 hours, researchers found that insertion-to-delivery time was significantly shorter with 6-hour removal (19.2 vs. 24.3 hours, p=0.04). They also found that the proportion of women delivered by 24 hours to be significantly greater with 6-hour removal (67% vs. 47%, p<0.01).

No differences were found, however, in cesarean delivery rates (19% vs. 28%, p=0.15) or other maternal and neonatal outcomes.

The women had similar baseline characteristics, including parity (71% nulliparous in the six-hour group and 68% in the twelve-hour group; p=).

Clinical protocols should consider decreasing the planned length of time a cook catheter is in place.

“Overall, this study is reproductive for other labor delivery units,” said Sarah C. Lassey, MD, presenter and lead study author. “However, it is not without limitations, since the population was somewhat homologous and not blinded to ripening time.”

Lassey practices in the Division of Maternal-Fetal Medicine at Brigham and Women’s Hospital in Boston and with Diagnostic Ultrasound Associates, PC in Brookline, MA. She is an instructor at Harvard Medical School.