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Double-balloon catheter and sequential vaginal prostaglandin E2 versus vaginal prostaglandin E2 alone for induction of labor after previous cesarean section

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the efficacy of inducing labor using a double-balloon catheter and vaginal prostaglandin E2 (PGE2) sequentially, in comparison with vaginal PGE2 alone after previous cesarean section.

Methods

A total of 264 pregnant women with previous cesarean section undergoing labor induction at term were included in this prospective multicentre cohort study. Induction of labor was performed either by vaginal PGE2 gel or double-balloon catheter followed by vaginal PGE2. The primary outcome measure was the cesarean section rate.

Results

The cesarean section rate was 37 % without any statistically significant difference between the two groups (PGE2: n = 41, 37 % vs. balloon catheter/PGE2: n = 41, 42 %; P = 0.438). The median (range) number of applications of PGE2 [2 (1–10) versus 1 (0–8), P < 0.001] and the total amount of PGE2 used in median (range) mg [2 (1–15) vs. 1 (0–14), P = 0.001] was less in the balloon catheter/PGE2 group. Factors significantly increasing risk for cesarean section were “no previous vaginal delivery” (OR 5.391; CI 2.671–10.882) and “no oxytocin augmentation during childbirth” (OR 2.119; CI 1.215–3.695).

Conclusions

The sequential application of double-balloon catheter and vaginal PGE2 is as effective as the sole use of vaginal PGE2 with less applications and total amount of PGE2.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Erlangen University Hospital, Universitätsstraße 21-23, 91054, Erlangen, Germany

    Sven Kehl, Ulf Dammer, Jutta Heimrich, Florian Faschingbauer & Matthias W. Beckmann

  2. Department of Obstetrics and Gynecology, University Medical Center Mannheim, Heidelberg University, Heidelberg, Germany

    Sven Kehl & Marc Sütterlin

  3. Department of Medical Statistics and Biomathematics, University Medical Center Mannheim, Heidelberg University, Heidelberg, Germany

    Christel Weiss

  4. Department of Obstetrics and Gynecology, Hospital Memmingen, Memmingen, Germany

    Michael Wamsler

  5. Department of Obstetrics, Jena University Hospital, Jena, Germany

    Jana Beyer & Ekkehard Schleussner

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  1. Sven Kehl
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Correspondence to Sven Kehl.

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Kehl, S., Weiss, C., Wamsler, M. et al. Double-balloon catheter and sequential vaginal prostaglandin E2 versus vaginal prostaglandin E2 alone for induction of labor after previous cesarean section. Arch Gynecol Obstet 293, 757–765 (2016). https://doi.org/10.1007/s00404-015-3907-7

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