[Retrospective comparison of effectiveness of balloon catheter versus dinoprostone for cervical ripening]

Abstract

Objective: To compare the effectiveness and the safety of cervical ripening between two methods: the Cook double balloon catheter and the dinoprostone pessary (Propess 10mg).

Methods: We performed a retrospective comparative study in a French maternity. We analyzed 404 women with induction of labour after 37 gestational weeks, with singleton cephalic live fetus, unscarred uterus, unruptured membranes, and Bishop score<6. The primary endpoint was the time between the start of the ripening and the delivery. Secondary endpoints include effectiveness and safety outcomes of the methods.

Results: Compared to dinoprostone pessary, the balloon catheter was associated with a longer time to delivery (34.4±16.5 vs 25.5±15.3h; P<0.001). This difference is found in both primiparous and multiparous women. Balloon catheter is also associated with a smaller improvement of the Bishop score (2.5±2.1 vs 4.2±2.9 Bishop's points; P<0.001) and more failure to achieve delivery in 24h (32.3% vs 56.7%; P<0.001). There was no difference in mother and fetal safety.

Conclusion: In this retrospective study, cervical ripening using balloon catheter seems to lengthen the induction of labour. No difference in safety outcomes with dinoprostone was found.

Keywords: Ballonnet extra-amniotique; Balloon catheter; Cervical ripening; Dinoprostone; Déclenchement du travail; Induction of labor; Maturation cervicale.