Women satisfaction on choosing the cervical ripening method: Oral misoprostol versus balloon catheter

Emeline Flament; Pauline Blanc-Petitjean; Antoine Koch; Philippe Deruelle; Camille Le Ray; Nicolas Sananès

doi:10.1016/j.eurox.2023.100202

Women satisfaction on choosing the cervical ripening method: Oral misoprostol versus balloon catheter

Eur J Obstet Gynecol Reprod Biol X. 2023 Jun 16:19:100202. doi: 10.1016/j.eurox.2023.100202. eCollection 2023 Sep.

Authors

Emeline Flament¹, Pauline Blanc-Petitjean², Antoine Koch¹, Philippe Deruelle¹, Camille Le Ray³, Nicolas Sananès^{1

4}

Affiliations

¹ Department of Obstetrics and Gynecology, Strasbourg University Hospital, 1 Avenue Moliere, 67200 Strasbourg, France.
² Department of Epidemiology and Public Health, Rennes University Hospital, 2 Rue Henri Leguilloux, 35033 Rennes, France.
³ Port-Royal Maternity Unit, Assistance Publique-Hôpitaux de Paris, Hôpital Cochin, FHU préma, 123 Bd de Port-Royal, 75014 Paris, France.
⁴ INSERM 1121 'Biomaterials and Bioengineering', Strasbourg University, 1 Pl. de l'Hôpital, 67000 Strasbourg, France.

Abstract

Objective: Induction of labor concerns about 29 % of women in Unites States and 33 % in Europe. Among the various methods for cervical ripening, the efficacy and safety profiles of oral misoprostol and balloon catheter are comparable, but data in the literature on maternal satisfaction during induction of labor are few. The objective of this study was to assess the satisfaction of women who chose the method of cervical ripening, i.e. either balloon catheter or oral misoprostol, for induction of labor.

Study design: This retrospective study asked women who had undergone induction of labor between February 1, 2020 and February 28, 2021. After receiving verbal and written information, the choice of method between oral misoprostol and balloon catheter was left to the patient's free appreciation. Satisfaction was assessed by means of a questionnaire distributed to all women during their stay in the maternity unit. The principal assessment criterion was based on women' inclination to choose the same cervical ripening method if induction of labor were to prove necessary in a future pregnancy, and their willingness to recommend this method to a friend. Univariate analyses were conducted using Student's t-test, Chi-2 test or Fisher's exact test.

Results: On 575 women eligible for analysis, 365 (63.5 %) of these women replied to the satisfaction questionnaire. Of this number, 236 (64.7 %) chose cervical ripening by balloon catheter, and 129 (35.3 %) by oral misoprostol. No significant difference was found between the two groups: 68.2 % of women in the balloon catheter group would opt for the same method of cervical ripening if it proved necessary in a future pregnancy and 64.7% would recommend it to a pregnant friend, versus 65.9 % and 63.6 % in the oral misoprostol group, respectively. Women were overall pleased to be able to choose their method of cervical ripening: 90.5 % of patients in the balloon catheter group and 95.3 % in the oral misoprostol group.

Conclusions: When women choose the method of cervical ripening, satisfaction is overall good, irrespective of the method, whether by balloon catheter or misoprostol.

Keywords: Balloon catheter; Cervical ripening; Induction of labor; Maternal satisfaction; Prostaglandins.