Which is the safer method of labor induction for oligohydramnios women? Transcervical double balloon catheter or dinoprostone vaginal insert.

Abstract

OBJECTIVE:

To compare the effectiveness and safety of two cervical ripening methods in term primiparous women with unfavorable cervices and oligohydramnios.

METHODS:

Women (126 cases) with oligohydramnios [amniotic fluid index (AFI) ≤5 cm] and a low Bishop Score (≤6) were assigned randomly to use double balloon catheter (mechanical method group, 67 cases) or dinoprostone 10 mg controlled-release vaginal insert (pharmacological method group, 59 cases) for induction of labor. The study's primary outcome was caesarean section rate (CSR). The secondary outcome measures included maternal and neonatal morbidity, an incremental changes in Bishop Score, and intrapartum interventions.

RESULTS:

There was no significant difference between the mechanical method group and the pharmacological method group in CSR and change in Bishop Score. Tacysystole, non-reassuring fetal heart patterns, and cases of newborn umbilical-cord arterial blood pH<7.1 were significantly lower with the mechanical method compared with the pharmacological method (p < 0.05). More patients needed additional intervention in the mechanical method group.

CONCLUSIONS:

Both methods resulted in a similar CSR. Double balloon catheter resulted in fewer labor complications, but more frequent use of oxytocin and amniotomy. Compared with dinoprostone vaginal insert, double balloon catheter use may be less problematic in women with oligohydramnios.

• Authors: WenYan Wang, Jianlan Zheng, JingLi Fu, XiaoQiong Zhang, QinLing Ma, ShuiLan Yu, MeiYing Li, Li Hou
• Journal: The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians (J Matern Fetal Neonatal Med) Vol. 27 Issue 17 Pg. 1805-8 (Nov 2014) ISSN: 1476-4954 [Electronic] England
• PMID: 24397441 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Drug Implants
• Oxytocics
• Dinoprostone

Topics

• Administration, Intravaginal
• Adult
• Catheterization (adverse effects, instrumentation, methods)
• Cervical Ripening (drug effects)
• Cesarean Section (statistics & numerical data)
• Dilatation (instrumentation, methods)
• Dinoprostone (administration & dosage, adverse effects)
• Drug Implants
• Female
• Humans
• Infant, Newborn
• Labor, Induced (adverse effects, statistics & numerical data)
• Oligohydramnios (epidemiology, therapy)
• Oxytocics (administration & dosage, adverse effects)
• Parity
• Pregnancy
• Term Birth
• Young Adult