Comparing Effectiveness of Dinoprostone Gel and Single Foley’s Catheter for Medical Termination of Pregnancy with Previous Caesarean Scar

Abstract

Women who have had a previous caesarean scar and are undergoing medical termination of pregnancy (MTP) have shown encouraging results from both chemical induction with Dinoprostone gel and mechanical induction of labour with Foley's catheter. T o assess and contrast the efficacy of a single Foley's catheter and Dionoprostone gel for medical termination of pregnancy (MTP) in patients who have had a prior caesarean section. The Department of Fetomaternal Medicine at BMU, Dhaka, carried out this quasi-experimental study from December 2023 to November 2024. The study population consisted of all patients with a history of caesarean scarring during the study period who were listed for medical termination of pregnancy within 14–28 weeks of gestation. A purposive sampling method was used to select 60 participants, who were assigned to Group A (single Foley’s catheter = 30) and Group B (Dinoprostone gel = 30). The collected data was evaluated for accuracy, consistency, and completeness prior to analysis. To analyse the data, SPSS version 23.0 was used. Among 60 participants, baseline demographics were comparable between Group A (Dinoprostone, n=30) and Group B (Foley’s, n=30): age 18–34 years in 27 (90.0%) each (p=0.715), SSC–HSC education in 12 (40.0%) each (p=0.199). Comorbidities like DM [Group A: 10 (33.3%), Group B: 9 (30.0%)], and HTN [9 (30.0%) vs 6 (20.0%)] were similar. Induction success was higher in Group A: 28 (93.3%) vs 19 (63.3%) (p=0.004). Time to labor and delivery was shorter in Group A: 16.1 ± 6.6 hrs vs 23.3 ± 8.6 (p=0.001); 24.8 ± 7.1 hrs vs 31.2 ± 9.3 (p=0.004). Hospital stays <3 days: 18 (60.0%) vs 9 (30.0%) (p=0.019). Dinoprostone gel was more effective and time-efficient than a single Foley’s catheter for pregnancy termination in women with cesarean scars, with higher success rates and shorter hospital stays, without increasing maternal complications.

DOI: https://doi.org/10.52783/jchr.v15.i5.10068