Foley Balloons for cervical ripening?

tntblonde · Mar 6, 2007

someone tell me exactly what a foley ripening is, we don't do them at our facility

jenrninmi, MSN, RN · Mar 6, 2007

someone tell me exactly what a foley ripening is, we don't do them at our facility

:stone It's explained in several of the posts above.:stone

tntblonde · Mar 6, 2007

sorry this was my first post and duhhh didn't realize there were previous discussions... after reading through them... this sounds like a pretty old practice! we use pit, cervidil and cytotec. mostly just plain old pit, and not low dose!..

SmilingBluEyes · Mar 7, 2007

no worries, tnt! if you have questions or need assistance navigating our site, please feel free to ask or private message me. i am glad you joined us, welcome to allnurses.com!

Gompers, BSN, RN · Mar 8, 2007

I underwent this lovely procedure when I was induced in December. I will NEVER do it again. Overall bad experience. I was originally supposed to get cervidil but when I checked into L&D, I was having irregular contractions due to dehydration. Even after giving me a fluid bolus and starting a maintenance IV, the OB still wasn't comfortable going with cervidil because she didn't want to cause hyperstimulation of my already contracting uterus. So my only option, besides starting pit on a semi-ripe cervix (1cm, 50%) was the foley.

OUCH. I don't know if I just have a more sensitive cervix or what, but OUCH.

After the insertion, the foley was taped to my leg in such a way as to put PRESSURE on my cervix to encourage dilation. Walking was very uncomfortable, both because of the cervical irritation and because of all the tape on my leg and lack of slack with the foley. I was given two liters of saline for the dehydration and was denied a bedpan - they wanted me to walk around as much as possible. Thing was, I was being induced overnight with this foley and the pit was to be started in the morning. So basically I was up almost every hour that night to painfully shuffle to the bathroom, then had to face an entire day of pit after that! Is it any wonder why, around midnight, I begged for a c-section out of exhaustion? Geez.

While the foley did do it's job - I was dilated to 4cm by the morning and my water broke naturally a few hours after the foley was removed and the pit was started - it took a lot longer for me to progress (24 hours from the time of insertion until I was 10cm) than most of the women I know who had cervidil instead. I agree that while it may help dilation, it obviously does nothing for ripening the cervix and is very uncomfortable to boot.

One strange thing my hospital does that no one seemed to mention here is that they don't inflate the foley and then cap it off - they continuously infuse it with sterile saline to keep it at 30cc. Something about infection, I was told. Well, two things happened: one was that my chux covered bed was WET all night long from the leaking, so even in those few minutes where I could finally sleep I was uncomfortable - and two, I got a uterine infection anyways!!!

Sorry to go on and on, but it was just a very negative experience.

crysobrn · Mar 8, 2007

We no longer use the foley balloons for cervical ripening. We are a smaller OB unit with only 2 OB's now. No midwives. We had an OB a while ago that did use the foleys and then I think the nursing staff was uncomfortable with it since we do not have a dr available, like I said small hospital.

Ok so the thing that irritates me is that we are doing all these inductions at night period. These moms are exhausted because they are being monitored all night. We mostly do cervidil now which is inserted in the evening, the patients often have no idea they should have IV access as well as the fact they will need to be pretty much continuously monitored all night long. I have suggested over and over that we do cervidil during the day and then let them sleep if no spont labor has started and then the next morning we should start pit and do AROM so that they get a nights sleep. I think you get my drift here.

Oh and in response to the ambien. Very rarely do our OB's use it. Only if we have someone that has to be in the hospital for an ext period of time and c/o lack of sleep.

nursejohio, ASN, RN · Mar 8, 2007

Aww Gompers... Sorry you had such a rough time of it. I've seen the foley bulbs work really well and moms go from closed to complete in 6 hours, and I've seen them take 12 or more hours to get from 1 to 4. It just depends.

The continuous irrigation thing is determined doc to doc. Some of them run normal saline up through the foley to help irritate the uterus and make it start contracting better, others just tape it for traction and some do both. I've never heard them explain the EASI as having anything to do with infection though, I'll have to ask next time I work.

How is your little angel doing these days?

SmilingBluEyes · Mar 8, 2007

I underwent this lovely procedure when I was induced in December. I will NEVER do it again. Overall bad experience. I was originally supposed to get cervidil but when I checked into L&D, I was having irregular contractions due to dehydration. Even after giving me a fluid bolus and starting a maintenance IV, the OB still wasn't comfortable going with cervidil because she didn't want to cause hyperstimulation of my already contracting uterus. So my only option, besides starting pit on a semi-ripe cervix (1cm, 50%) was the foley.
OUCH. I don't know if I just have a more sensitive cervix or what, but OUCH.
After the insertion, the foley was taped to my leg in such a way as to put PRESSURE on my cervix to encourage dilation. Walking was very uncomfortable, both because of the cervical irritation and because of all the tape on my leg and lack of slack with the foley. I was given two liters of saline for the dehydration and was denied a bedpan - they wanted me to walk around as much as possible. Thing was, I was being induced overnight with this foley and the pit was to be started in the morning. So basically I was up almost every hour that night to painfully shuffle to the bathroom, then had to face an entire day of pit after that! Is it any wonder why, around midnight, I begged for a c-section out of exhaustion? Geez.
While the foley did do it's job - I was dilated to 4cm by the morning and my water broke naturally a few hours after the foley was removed and the pit was started - it took a lot longer for me to progress (24 hours from the time of insertion until I was 10cm) than most of the women I know who had cervidil instead. I agree that while it may help dilation, it obviously does nothing for ripening the cervix and is very uncomfortable to boot.
One strange thing my hospital does that no one seemed to mention here is that they don't inflate the foley and then cap it off - they continuously infuse it with sterile saline to keep it at 30cc. Something about infection, I was told. Well, two things happened: one was that my chux covered bed was WET all night long from the leaking, so even in those few minutes where I could finally sleep I was uncomfortable - and two, I got a uterine infection anyways!!!
Sorry to go on and on, but it was just a very negative experience.

Sounds a lot like the experiences told to me by patients who have undergone foley inductions. None of them liked the experience, all ranked it as horribly painful. But then, so is labor.....At least w/foleys, you don't involve artificially-introduced chemical changes like you would with prostaglandin placements. No form of induction is at all comfortable and all are risky.

Artificially-induced labor is often more intense and painful no matter how we do it. And as with prostaglandins, they either work out or not. Very unpredictable. Mother Nature still has the upper hand on us.