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