Termination of Second Trimester Pregnancy: Extra Amniotic Foley’s Catheter Balloon with Traction versus Combined use of Foley’s Catheter Balloon and Extra Amniotic Instillation of PGF2 alpha

Abstract

Background: Termination of pregnancy in second trimester due to intrauterine foetal death and foetal abnormalities is one of the big challenges faced by the obstetricians today. The objectives of this study were to determine the frequency of indications for termination of 2nd trimester pregnancy and to compare the efficacy of extra amniotic Foley’s catheter balloon with traction vs. combined use of Foley’s catheter balloon and extra amniotic instillation of PGF2 alpha for therapeutic termination of second trimester pregnancy. Material & Methods: It was a comparative cross sectional study carried out in the Department of Obstetrics and Gynaecology of Saidu Group of Teaching Hostitals, Swat, Pakistan in year 2011. A sample of 73 patients was selected by convenience sampling. Inclusion criteria were pregnant women, 14-26 weeks of gestation with foetal intra uterine death or lethal congenital malformations. The exclusion criteria were placenta previa, unexplained vaginal bleeding and vaginal discharges, and those with absent membrane. Patients were randomised into two groups by simple lottery method. The group 1 patients were induced with Foley’s catheter balloon alone with traction while group 2 patients were induced with combined Foley’s catheter balloon and PGF2-alpha. Results: Mean induction to products expulsion interval was significantly shorter in the group 2 as compared to group 1 (16.7±4 versus 26.2±11.019 hrs, p<0.005). Conclusion: The combined use of Foley’s catheter balloon with extra amniotic instillation of PGF2-alpha is more efficacious than the Foley’s catheter balloon with traction alone.