[Cervical ripening: is there an advantage for a double-balloon device in labor induction?]

Abstract

Objectives: To compare efficiency of a double-balloon to vaginal prostaglandins for cervical ripening in patients with unfavourable cervix.

Patients and methods: Fifty patients induced with a double-balloon were compared to 50 patients receiving vaginal prostaglandins. Matching criteria were age, parity, history of uterine scar, gestational age and Bishop score. The primary outcome was failure induction. Secondary outcomes included improvement in Bishop score, ripening-to-delivery interval, caesarean section rate, maternal and neonatal morbidity.

Results: Risk of failed induction (16% in the double-balloon group vs. 14% in the prostaglandins group) and caesarean section rate (28% vs. 36%) were similar in the two groups. The proportion of favourable cervix and the time to obtain a better Bishop score were similar with the two methods. Maximal pain score during cervical ripening was significantly lower in the double-balloon group (P<0.001). Ripening-to-delivery interval (30.4 h ± 15.6h vs. 28.9 h ± 20.5h) was not different between the two groups. There was no difference about maternal and neonatal outcomes.

Discussion and conclusion: The double-balloon was as efficient as vaginal prostaglandins. The ripening-to-delivery interval was not different between the two groups. The main advantage of this device could be a better tolerance favourishing patient satisfaction.

Keywords: Caesarean section; Cervical ripening; Césarienne; Double ballonnet; Double-balloon; Déclenchement artificiel du travail; Induction mécanique; Labor induction; Maturation cervicale; Mechanical methods.