Tugging the Foley catheter balloon every 3 h in nulliparous induction of labor: A randomized controlled trial.
Muhamad Aznor Aqwa Azman, Mukhri Hamdan, Thai Ying Wong et al.
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In 30 seconds
This randomized controlled trial at a university hospital in Malaysia compared forceful 30-second Foley balloon tugging every 3 hours with usual care during planned 12-hour balloon placement for labor induction in nulliparous patients. Among 264 participants, median induction-to-birth duration was 33.2 [25.3-43.4] hours with tugging versus 37.2 [27.9-45.8] hours with usual care (P = 0.058). Satisfaction scores were 9 [7-10] in both groups (P = 0.437). The authors concluded that scheduled tugging did not expedite birth or improve satisfaction.
Key findings
- Median induction-to-birth duration was 33.2 [25.3-43.4] hours with tugging versus 37.2 [27.9-45.8] hours with usual care (P = 0.058).
- Labor-induction satisfaction scores were 9 [7-10] in both groups (P = 0.437).
- Umbilical artery pH ≤7.10 occurred in 2/126 (1.6%) versus 3/129 (2.3%); relative risk 0.67 95% CI 0.11-3.95 P > 0.99.
Why it matters
Foley balloon induction is used to prepare the cervix, and this trial tested whether a simple scheduled maneuver could shorten the time to birth or improve the patient experience. Neither primary outcome differed significantly between groups. The findings help clarify that, in the studied nulliparous population and 12-hour placement protocol, routine tugging did not demonstrate these intended benefits.
What to keep in mind
The trial was conducted at one university hospital in Malaysia and studied nulliparous patients with a planned 12-hour Foley placement; applicability beyond this setting and protocol is uncertain.