Background: Induction of labour (IOL) is one of the most common obstetrical interventions worldwide. The choice of induction method remains a subject of debate, particularly regarding the balance between efficacy (time to delivery) and safety (maternal and fetal complications). While pharmacological agents like prostaglandins are widely used, mechanical methods such as the Foley catheter are gaining traction due to their low cost and favorable safety profile. Methods: A prospective cohort study was conducted at a tertiary care center involving 220 pregnant women with singleton, cephalic, term pregnancies (37–41 weeks) and a Bishop score < 6. Participants were assigned to receive either an intracervical Foley catheter (Group M, n=110) or intracervical Dinoprostone gel (Group P, n=110) based on clinical protocols and patient counseling. Key outcomes included the rate of Cesarean section (CS), induction-to-delivery interval, uterine hyperstimulation, and neonatal morbidity. Results: The baseline characteristics were comparable between groups. The rate of Cesarean section was lower in Group M (18.2%) compared to Group P (23.6%), though this did not reach statistical significance (P = 0.31). However, Group P exhibited a significantly shorter mean induction-to-delivery interval (16.4 ± 4.2 hours) compared to Group M (21.8 ± 5.1 hours; P < 0.001). Conversely, uterine hyperstimulation was significantly more frequent in Group P (7.3%) than in Group M (0.9%; P = 0.02). Neonatal outcomes, including APGAR scores and NICU admissions, showed no significant differences (NICU admission: 3.6% vs. 4.5%; P = 0.74). Conclusion: Mechanical induction with a Foley catheter is associated with a significantly lower risk of uterine hyperstimulation compared to Dinoprostone gel, making it a safer alternative for cervical ripening. While pharmacological induction offers a shorter interval to delivery, it does not significantly reduce the Cesarean section rate.

Background: Lactational breast abscess is a common complication of mastitis in breastfeeding women and contributes significantly to maternal morbidity. Traditional incision and drainage (I & D) remains a definitive treatment but is associated with pain, scarring, and prolonged recovery. Needle aspiration has emerged as a minimally invasive alternative. Aims and Objectives: This study compares the clinical outcomes of needle aspiration versus I&D in the management of lactational breast abscesses. Materials and Methods: This prospective comparative study included 120 lactating women with ultrasonographically confirmed breast abscesses at SMMH Medical College from January 2024 to January 2025. Participants were randomly assigned to two equal groups: Group A underwent needle aspiration, and Group B underwent incision and drainage. Outcomes assessed included healing time, residual abscess formation, number of procedures required, pain, cosmetic results, and microbiological profile. Statistical analysis was performed using SPSS version 20, with p < 0.05 considered significant. Results: Most abscesses measured 4–5 cm, and 84% of patients presented within six weeks postpartum. Needle aspiration resulted in significantly faster healing (mean 19.4 days) compared with I&D (30.4 days). Residual abscess occurred in 20% of aspiration cases, whereas none were observed in the I&D group (p = 0.041). Pain was substantially lower in the aspiration group, with analgesic use mainly limited to the first day. In contrast, patients undergoing I&D required several days of analgesics. Cosmetic outcomes strongly favoured aspiration: all successfully treated patients healed without scars, whereas all I & D patients developed visible scars. MRSA was the predominant organism (61%), followed by Staphylococcus aureus. Conclusion: Needle aspiration is an effective and cosmetically superior first-line treatment for uniloculated lactational breast abscesses up to 5 cm, offering faster healing and less pain. Incision and drainage should be reserved for large, multiloculated, or aspiration-resistant abscesses. The findings support wider adoption of minimally invasive management in suitable lactating women.