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Double-balloon catheter versus prostaglandin for cervical ripening to induce labor after previous cesarean delivery

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

Abstract

Purpose

To compare the effectiveness of cervical ripening by a mechanical method (double-balloon catheter) and a pharmacological method (prostaglandins) in women with one previous cesarean delivery, an unfavorable cervix (Bishop score < 6), and a singleton fetus in cephalic presentation.

Methods

This retrospective study, reviewing the relevant records for the years 2013 through 2017, took place in two French university hospital maternity units. This study included women with one previous cesarean delivery, a liveborn singleton fetus in cephalic presentation, and intact membranes, for whom cervical ripening, with unfavorable cervix (Bishop score < 6) was indicated for medical reasons. It compared two groups: (1) women giving birth in a hospital that uses a protocol for mechanical cervical ripening by a double-balloon catheter (DBC), and (2) women giving birth in a hospital that performed pharmacological cervical ripening by prostaglandins. The principal endpoint was the cesarean delivery rate. The secondary outcome measures were maternal and neonatal outcomes.

Results

We compared 127 women with prostaglandin ripening to 117 women with DBC. There was no significant difference between the two groups for the cesarean rate (42.5% in the prostaglandin group and 42.7% in the DBC group; p = 0.973; crude OR 1.01 [0.61–1.68]; adjusted OR 1.55 [0.71–3.37]). The median interval between the start of ripening and delivery did not differ between the groups (28.7 h in the prostaglandin group vs 25.6 h in the DBC group; p = 0.880). Neonatal outcomes did not differ between the groups, either. There was one case of uterine rupture in the prostaglandin group, with no associated maternal or neonatal morbidity. There were no neonatal deaths. The postpartum hemorrhage rate was significantly higher in the DBC group.

Conclusion

For cervical ripening for women with one previous cesarean, the choice of a pharmacological or mechanical protocol does not appear to modify the mode of delivery or maternal or neonatal morbidity.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Robert Debré Hospital, APHP, 42 Boulevard Sérurrier, 75019, Paris, France

    Diane Korb, Sarah Renard, Cécile Morin & Olivier Sibony

  2. Université de Paris, Epidemiology and Statistics Research Center/CRESS, INSERM, INRA, 75004, Paris, France

    Diane Korb

  3. Department of Obstetrics and Gynecology, Brest University Hospital, Brest, France

    Sarah Renard & Philipe Merviel

Authors
  1. Diane Korb
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  2. Sarah Renard
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  3. Cécile Morin
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  4. Philipe Merviel
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  5. Olivier Sibony
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Contributions

DK: Protocol/project development, Data collection or management, Data analysis, Manuscript writing/editing. SR: Data collection or management, Data analysis, Manuscript writing/editing. CM: Manuscript writing/editing. PM: Manuscript writing/editing. OS: Protocol/project development, Manuscript writing/editing.

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Correspondence to Diane Korb.

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Korb, D., Renard, S., Morin, C. et al. Double-balloon catheter versus prostaglandin for cervical ripening to induce labor after previous cesarean delivery. Arch Gynecol Obstet 301, 931–940 (2020). https://doi.org/10.1007/s00404-020-05473-x

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  • DOI: https://doi.org/10.1007/s00404-020-05473-x

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