Cervical Ballon Catheter

Last updated 08.03.13

Definition

- Insertion of a Foley catheter into the cervix for labour induction in pregnancy

Features

- Used for IOL

- Cervical ripening

- Mechanical method, non-pharmacological

Indications

- Bishop score <6: cervical ripening

- IOL during pregnancy

- When chemical induction less appropriate

Contraindications

- Spontaneous labour

- Abnormal CTG or known fetal compromise requiring immediate delivery

- Persistant maternal fever

- Transverse or oblique lie of foetus

- Existing contraindications to vaginal delivery

- VBAC (relative)

Equipment

- Vaginal speculum

- Lubricant

- 16 or 18G Foley catheter

- Spigot

- IDC insertion pack

- Sterile gloves

- Sponge forceps x2

- Chlorhexidine

- Sterile water 50mls

- Syringe: 50mls

- Tape

Procedure

- Explanation & consent

- Typically done night prior to day of planned induction

- Normal CTG for 30min prior

- Lithotomy position

- VE with Bishop score <6

- Speculum examination

- +/- Prepare cervix with chlorhexidine

- +/- grasp edge of cervix with spongue forceps

- Pass Foley catehter through internal os of cervix using spongue forceps

- Inflate balloon with 50mls of sterile water

- Spigot catheter

- Gently withdraw Foley catheter until balloon rests aginst internal os

- Check that catheter has not dislodged into vagina

- Secure catheter to inner thigh with tape with small amount of traction

- CTG for 30min+ post insertion

- Remove Foley catheter if

- Uterine hyperstimulation

- Non-reassuring CTG

- Maternal fever

- Maternal discomfort

- Ruptured membranes

- Remove Foley catheter morning of induction

- May fall out independantly if cervix dilates (as intended)

- Deflate balloon

- Withdraw Foley catheter

- VE to assess for ARM

Complications

- Dislodgement of catheter without dilatation

- Maternal discomfort

- PV bleeding post insertion: should settle

References

Western Health: Induction of Labour Feb 2013