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Objective:To evaluate if a learning curve exists for cervical Foley placement for labor induction in women with unfavorable cervices and whether labor curves differ compared with the dinoprostone insert (PGE2).Study Design:We conducted a secondary analysis of a multicenter randomized controlled trial.Result:For Foley and PGE2, successful placement occurred in 157/185 (85%) and 188/191 (98%) women (P<0.001). Unsuccessful Foley placements decreased over time (P=0.005); all occurred at the site previously using PGE2 preferentially. In women with allocated agent placed successfully who achieved complete cervical dilation, median progress with Foley (n=112), compared with PGE2 (n=123), was: 1–3 cm (6.2 vs 14.1 h; P<0.001), 3–6 cm (11.1 vs 6.7 h; P<0.001) and 6–10 cm (1.9 vs 1.5 h; P=0.14).Conclusion:There is a learning curve for placing cervical Foley catheters. Despite faster times to delivery, Foley is associated with slower dilation from 3 to 6 cm compared with PGE2.

A major effort to decrease preterm birth rates is directed at preventing recurrent spontaneous preterm birth in singleton pregnancies. Shortened cervical length is one predictor of spontaneous preterm birth, and cervical pessary and cerclage are often used. This study was undertaken to compare the outcomes in women with a singleton pregnancy and history of preterm birth and sonographic short cervix, managed with cerclage, vaginal progesterone, or cervical pessary.