Increased risk of cervical canal infections with intracervical foley catheter

Objective: To evaluate the effect of intracervical Foley catheter insertion, for the induction of labor, on cervical canal infection. Design: A prospective interventional study with paired analysis. Place and Duration of Study: The study was conducted in the department of Obstetrics and Gynecology at the Aga Khan University, Karachi, between June 1 and August 31, 2002. Subjects and Methods: In 45 women undergoing cervical ripening with intracervical Foley catheter for the induction of labour at term, cervical swabs were taken for culture and sensitivity before its insertion and again after its spontaneous expulsion or removal. Results: Intracervical Foley catheter was retained for mean duration of 8.1 ± 1.7 hours. There was a significant change in the pathogenic organisms (0% v 16.3%; p 0.016) from pre-Foley to post-Foley catheter cervical swab cultures. Growth of β-bemolytic Streptococcus group-B, Candida albicans, Candida glabrata and Gardnerella vaginalis on cervical swab were considered pathogenic. One woman (2.2%) developed fever following insertion of intracervical Foley catheter. No statistically significant effect of potential confounding factors was observed on change in growth of pathogenic organisms. Conclusion: Induction of labour at term with Foley catheter is associated with a significant increase in intracervical pathogenic organisms despite undertaking routine aseptic measures. We recommend evaluation of this technique for its potential infectious harm in larger studies. Meanwhile, extreme aseptic measures should be undertaken during its insertion to avoid maternal and possible neonatal infections.