|October 2002 · Vol. 14, No. 10
Simplified Foley insertion for cervical ripening
When a urologic sound is used as a stiffener, the clumsy, uncomfortable process of Foley-catheter positioning is transformed into a straightforward tactile insertion. The author details this simple, effective technique and discusses its advantages over alternative methods.
Dr. Freedman is on the active staff of the Wyoming Valley Health Care Systems (Nesbitt Memorial and Wilkes-Barre General Hospitals) and adjunct professor of clinical medicine at King’s College in Wilkes-Barre, Pa.
A 16-Foley catheter allows the stiffener to pass through with ease; a 30-mL balloon allows for maximum balloon circumference utilizing a minimal amount of fluid.
Hold the Foley catheter with internal stylet between the first 2 fingers of your dominant hand, then insert the ripener into the patient’s vagina up to the cervix.
Position a finger on either side of the cervical opening, slide the catheter into the os until it touches the fetal vertex, and inflate the balloon.
If the Foley is not spontaneously expelled, deflate the balloon and remove catheter within 5 to 12 hours, depending on time of induction.
The Foley balloon is inexpensive and safe to use after ruptured membranes or in a trial of labor following a previous cesarean.
Postterm pregnancy, hypertensive disorders, diabetes mellitus, premature rupture of membranes, chorioamnionitis, perceived intrauterine growth restriction or macrosomia, oligohydramnios—these are just a few of many conditions that may call for induction of labor via cervical ripening. Historically, though, this process has been laborious due to the difficult insertion of mechanical agents and the adverse effects of pharmacologic therapies.
When a urologic sound is added as a stiffener to typical Foley balloon catheter insertion, however, cervical ripening becomes a much simpler, straightforward procedure. Here I will describe proper placement techniques and detail this procedure’s benefits over other, more arduous methods.