LABOR OUTCOMES OF TRANSCERVICAL FOLEY CATHETER FOR CERVICAL RIPENING AND ASSOCIATED FACTORS AT WALLAGA UNIVERSITY COMPREHENSIVE SPECIALIZED HOSPITAL, ETHIOPIA

Background: Cervical ripening is essential for successful induction of labor when the cervix is unfavorable. The transcervical Foley catheter is a safe, low-cost mechanical method recommended in resource-limited settings. At Wallaga University Comprehensive Specialized Hospital (WUCSH), it is widely used; yet no recent study has evaluated its labor outcomes or identified factors predicting successful vaginal delivery. Without local evidence, clinical decisions and patient counseling rely on external data, which may not reflect this population. Objective: To assess labor outcomes of transcervical Foley catheter use for cervical ripening and identify associated factors at Wallaga University Comprehensive Specialized Hospital, Ethiopia. Methods: A retrospective cross-sectional study was conducted among 169 women who underwent cervical ripening with a transcervical Foley catheter from January to December 2025. Data were analyzed using SPSS version 27. Bivariate and multivariate logistic regression analyses were performed to identify factors associated with successful vaginal delivery within 24 hours. A p-value < 0.05 was considered statistically significant. Results: The proportion of women who achieved successful vaginal delivery within 24 hours was 68.6% ((116/169; 95% CI: 61.1% – 75.5%)). The mean induction-to-delivery interval was 15.98 ± 3.25 hours, and the cesarean section rate was 31.4%. The mean Bishop score increased from 4.57 ± 0.50 to 9.17 ± 1.51 following Foley removal (p < 0.001). Multivariate analysis revealed that multiparity (AOR = 4.65, 95% CI: 1.37–15.85, p = 0.014) and shorter Foley duration (AOR = 0.63, 95% CI: 0.41–0.98, p = 0.039) were independent predictors of success. The model showed good fit (Hosmer-Lemeshow p = 0.769) and 79.0% predictive accuracy. Conclusion: The transcervical Foley catheter is an effective first-line mechanical method for cervical ripening at WUCSH, achieving successful vaginal delivery within 24 hours in over two-thirds of women. However, success is strongly dependent on parity—nulliparous women have substantially lower odds and should be counseled accordingly and monitored more closely. The hospital should standardize protocols and audit outcomes regularly to improve patient selection and reduce unnecessary cesarean sections. Keywords: Cervical ripening; Foley catheter; Induction of labor; Labor outcomes; Mode of delivery; Associated factors; Ethiopia