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- by Ashley, PICU RN Mar 11, '12I'm not an L&D nurse, but I've been watching A Baby Story and every once in awhile there will be a patient who is not progressing who has a foley inserted into the cervix to aid with cervical dilation. The foley is inserted through the cervix, the bulb is inflated and then pulled against the cervix, simulating pressure of the baby's head.
So I'm curious if you use this on your unit? Is it effective? Do the women continue to dilate after the foley is removed, or do they stop progressing again? How comfortable is this procedure?
Just things I wonder about. Thanks for your insight!
- Mar 11, '12 by heather092800These are done every once in a while in our unit.....just from my experience with them....they progress to about 4cm, the bulb falls out, and they dont progress. I have seen them work, but only a few times. Very uncomfortable as well, but then again.....not much is regarding labor
- Mar 12, '12 by strn96I have seen this done occasionally, and it sometimes works. I think if statistics were done, however, pts who had this procedure would have an incredibly high C/S rate because they tend to stop dilating again after the bulb falls out, even with other induction meds, ROM, etc. Most likely because their cervix was so unfavorable to start with.
- Mar 12, '12 by jkaeeI had the procedure done with my last pregnancy (had to be induced at 33 weeks due to BP issues turning into pre-eclampsia) and, as Heather mentioned above, it got be to 4 cm and then I stopped progressing. Considering that I had Pit and Mag and PCN running for 30 hours before I asked for a section, I didn't see the Foley bulb as really doing much of anything.
- Mar 12, '12 by ElvishI must be the oddball here, because they work pretty well on my unit, and a fair number of our IOLs are foley bulbs. It doesn't have quite the risk of Cytotec and saves the uterus (and baby) a few hours of artificial oxytocin. Our foley bulbs usually get placed at night, pt goes to sleep, it comes out in the AM (either removal or falling out) and they start pit, usually end up with a vaginal delivery.
- Mar 17, '12 by MomBabyUnitRNQuote from ElvishI'm an oddball too, Elvish. We often do foley inductions and they work well. I personally hate Cytotec ripenings.I must be the oddball here, because they work pretty well on my unit, and a fair number of our IOLs are foley bulbs. It doesn't have quite the risk of Cytotec and saves the uterus (and baby) a few hours of artificial oxytocin. Our foley bulbs usually get placed at night, pt goes to sleep, it comes out in the AM (either removal or falling out) and they start pit, usually end up with a vaginal delivery.
- Mar 17, '12 by dancinglambWe commonly use foleys with cervidil for IOL in our unit until the pts get to 4-5cm. At that point, they usually are AROM'd and get IV pitocin to get things moving along. Since they're presumably 4-5 (sometimes more) by then, they also are able - should they choose - to get an epidural before the pit is started. I've had moms sleep through the whole thing, others...well, maybe not so much.
- Mar 24, '12 by NurseNoraI hate seeing it used for elective inductions, but it's great for medically indicated inductions with an unripe cervix. ( in my opinion, if the cervix isn't ripe [soft,partially effaced, starting to dilate just a little] the elective induction should be put off until the body is more ready. But then I'm a bit of a granola who preferrs to let Mother Nature do her thing as much as possible.
- Mar 25, '12 by beachmomWe have a midwife that does foley bulb ripening. The doctors use Cytotec. I think she does it as it's more natural. I don't know statistics, but it seems like it's not as effective to start labor. Pit is often used after either the foley or Cytotec is used.