Induction of labor methods in isolated term oligohydramnios

  • Eyal KrispinEmail author
  • Tal Netser
  • Avital Wertheimer
  • Lina Salman
  • Rony Chen
  • Arnon Wiznitzer
  • Eran Hadar
Maternal-Fetal Medicine



To compare pregnancy outcomes following induction of labor with prostaglandins versus extra-amniotic balloon catheter indicated for term isolated oligohydramnios.

Study design

Retrospective cohort study of all women who underwent induction of labor due to term isolated oligohydramnios at a university affiliated medical center (2007–2016). The cohort was divided into two subgroups, according to induction method: vaginal prostaglandins E2 versus extra-amniotic balloon catheter. Primary outcomes were successful cervical ripening, defined as a Bishop score ≥ 8, and vaginal delivery rate. Secondary outcomes were neonatal adverse events.


Five hundred and ten women were included, of whom 454 (89%) underwent induction by prostaglandins and 56 (11%) by extra-amniotic balloon. Cervical ripening success rate was significantly higher in the prostaglandins group (89.4 vs. 76.79%, p = 0.006), as was the rate of vaginal delivery (77.53 vs. 48.21%, p < 0.0001). Induction with prostaglandins remained superior to extra-amniotic balloon in vaginal delivery rate following adjustment to potential confounders (aOR 3.470, 95% CI 1.296–9.296, p < 0.0001). Neonates delivered following induction with extra-amniotic balloon catheter were more often admitted to the neonatal intensive care unit (14.55 vs. 3.39%, p = 0.002).


Both prostaglandins and extra-amniotic balloon catheter are reasonable interventions for isolated term oligohydramnios. Prostaglandins were superior to extra-amniotic balloon both in cervical ripening success and in vaginal delivery rates.


Induction of labor Oligohydramnios Term Prostaglandins Extra-amniotic balloon 



Amniotic fluid index


Prostaglandins E1


Prostaglandins E2


Extra-amniotic balloon


Non-reassuring fetal heart rate


Neonatal intensive care unit


Author contributions

EK and EH contributed to the preliminary hypothesis, data collection, data analysis, manuscript writing and submission. TN contributed to data collection and analysis, and manuscript writing. AW and LS contributed to data collection and manuscript writing. AW and RC took part in the project development and drafts editing.



Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

Study was approved by our local institutional review board (Approval No, 0278-17-RMC).

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required. This article does not contain any studies with animals performed by any of the authors.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Rabin Medical CenterHelen Schneider Hospital for WomenPetach TikvaIsrael
  2. 2.Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael

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