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Use of foley catheter for cervical ripening

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The document provides guidelines for using a Foley catheter to induce cervical ripening. A Foley catheter can apply mechanical pressure to the cervix to induce ripening. Its use is restricted to patients with intact membranes and an unfavorable cervix who are 35 weeks gestation or more, after consulting with a pediatrician. The document outlines the steps for proper placement and monitoring of the catheter.

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Use of the Foley Catheter for Cervical Ripening NLC P/P# 6600.0607
Purpose: Induce cervical ripening by providing mechanical pressure directly on the cervix using the balloon device of a Foley catheter. Policy: Use of an indwelling balloon catheter for cervical ripening is restricted to patients with intact membranes and an unfavorable cervix. Caution should be used if this procedure is performed for women with a history of reconstructive uterine surgery. In patients who are 35 weeks gestation or less, the mother’s physician must consult with the Pediatrician before initiation of cervical ripening using the Foley catheter.
1. Assemble all necessary equipment. 2. Explain to patient the reason the physician has ordered the procedure. 3. Obtain written consent. 4. Assist patient in finding comfortable position in labor bed. 5. Apply Fetal Monitor to patient. 6. Obtain reassuring FHR pattern (notify physician if FHT strip not reactive). 7. Record blood pressure, FHT, contraction frequency, duration and quality (if present), pulse, respirations every thirty to sixty (60) minutes in Labor Progress Notes. 8. Assist physician with placement of balloon dilator and inflation with normal saline.
8. Position catheter bag on bed in between patient’s legs to help put pressure on the cervix. 9. Document procedure, patient response to procedure, blood pressure, FHT’s, contraction frequency, duration and quality (if present), pulse, and respirations in the Labor Progress notes immediately following the procedure. 10. Continue to monitor and document patient’s blood pressure, FHT’s, contraction frequency, duration and quality (if present), pulse, respirations every thirty to sixty (30-60) minutes in Labor Progress Notes.
11. Deflate the Foley bulb and remove if the following occur: • Rupture of membranes • Fever • Bleeding • Uterine hyper-stimulation • Patient’s blood pressure is over 20 mm/hg – systolic, and/or if SBP 140 or greater/DBP 100 or greater. 12. Notify physician immediately if any adverse reaction to procedure is noted in mother or fetus, and document notification and appropriate nursing actions taken in the Labor Progress Notes. 13. Check current FHR pattern with baseline pattern to ensure fetal well being. 14. Remove catheter balloon six (6) hours after insertion, or at the time of spontaneous expulsion, or rupture of membranes (whichever occurs first).

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Use of foley catheter for cervical ripening

  • 1. Use of the Foley Catheter for Cervical Ripening NLC P/P# 6600.0607
  • 2. Purpose: Induce cervical ripening by providing mechanical pressure directly on the cervix using the balloon device of a Foley catheter. Policy: Use of an indwelling balloon catheter for cervical ripening is restricted to patients with intact membranes and an unfavorable cervix. Caution should be used if this procedure is performed for women with a history of reconstructive uterine surgery. In patients who are 35 weeks gestation or less, the mother’s physician must consult with the Pediatrician before initiation of cervical ripening using the Foley catheter.
  • 3. 1. Assemble all necessary equipment. 2. Explain to patient the reason the physician has ordered the procedure. 3. Obtain written consent. 4. Assist patient in finding comfortable position in labor bed. 5. Apply Fetal Monitor to patient. 6. Obtain reassuring FHR pattern (notify physician if FHT strip not reactive). 7. Record blood pressure, FHT, contraction frequency, duration and quality (if present), pulse, respirations every thirty to sixty (60) minutes in Labor Progress Notes. 8. Assist physician with placement of balloon dilator and inflation with normal saline.
  • 4. 8. Position catheter bag on bed in between patient’s legs to help put pressure on the cervix. 9. Document procedure, patient response to procedure, blood pressure, FHT’s, contraction frequency, duration and quality (if present), pulse, and respirations in the Labor Progress notes immediately following the procedure. 10. Continue to monitor and document patient’s blood pressure, FHT’s, contraction frequency, duration and quality (if present), pulse, respirations every thirty to sixty (30-60) minutes in Labor Progress Notes.
  • 5. 11. Deflate the Foley bulb and remove if the following occur: • Rupture of membranes • Fever • Bleeding • Uterine hyper-stimulation • Patient’s blood pressure is over 20 mm/hg – systolic, and/or if SBP 140 or greater/DBP 100 or greater. 12. Notify physician immediately if any adverse reaction to procedure is noted in mother or fetus, and document notification and appropriate nursing actions taken in the Labor Progress Notes. 13. Check current FHR pattern with baseline pattern to ensure fetal well being. 14. Remove catheter balloon six (6) hours after insertion, or at the time of spontaneous expulsion, or rupture of membranes (whichever occurs first).