Open AccessBalloon catheter for induction of labor in women with one previous cesarean and an unfavorable cervix
Author(s) -
Huisman Claartje M. A.,
Eikelder Mieke L. G.,
Mast Kelly,
Oude Rengerink Katrien,
Jozwiak Marta,
Dunné Frédérique,
Duvekot Johannes J.,
Eyck Jim,
GauglerSenden Ingrid,
de Groot Christianne J. M.,
Franssen Maureen T. M.,
Gemund Nicolette,
Langenveld Josje,
Leeuw Jan Willem,
Oude Lohuis Eefje J.,
Oudijk Martijn A.,
Papatsonis Dimitri,
Pampus Mariëlle,
Porath Martina,
Romboutde Weerd Sabina,
van Roosmalen Jos J.,
Salm Paulien C. M.,
Scheepers Hubertina C. J.,
Sikkema Marko J.,
Sporken Jan,
Stigter Rob H.,
van Wijngaarden Wim J.,
Woiski Mallory,
Mol Ben Willem J.,
Bloemenkamp Kitty W. M.
Publication year - 2019
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/aogs.13558
Subject(s) - medicine , cervix , obstetrics , uterine rupture , odds ratio , labor induction , prospective cohort study , pregnancy , cohort study , vaginal delivery , confidence interval , gynecology , uterus , surgery , oxytocin , cancer , biology , genetics , pathology
When women with a previous cesarean section and an unfavorable cervix have an indication for delivery, the choice is to induce labor or to perform a cesarean section. This study aims to assess the effectiveness and safety of a balloon catheter as a method of induction of labor in women with one previous cesarean section and an unfavorable cervix compared with an elective repeat cesarean section. Material and methods We performed a prospective cohort study in 51 hospitals in the Netherlands on term women with one previous cesarean section, a live singleton fetus in cephalic position, an unfavorable cervix and an indication for delivery. We recorded obstetric, maternal and neonatal characteristics. We compared the outcome of women who were induced with a balloon catheter with the outcome of women who delivered by elective repeat cesarean section. Main outcomes were maternal and neonatal morbidity. Mode of delivery was a secondary outcome for women who were induced. Adjusted odds ratios ( aOR ) were calculated using logistic regression, adjusted for potential confounders. Results Analysis was performed on 993 women who were induced and 321 women who had a repeat cesarean section (August 2011 until September 2012). Among the women who were induced, 560 (56.4%) delivered vaginally and 11 (1.1%) sustained a uterine rupture. Composite adverse maternal outcome (uterine rupture, severe postpartum hemorrhage or postpartum infection) occurred in 73 (7.4%) in the balloon and 14 (4.5%) women in the repeat cesarean section group ( aOR 1.58, 95% confidence interval [CI] 0.85‐2.96). Composite adverse neonatal outcome (Apgar score <7 at 5 minutes or umbilical pH <7.10) occurred in 57 (5.7%) and 10 (3.2%) neonates, respectively ( aOR 1.40, 95% CI 0.87‐3.48). Women who were induced had a shorter postpartum admission time (2.0 vs 3.0 days ( P < 0.0001)). Conclusions In women with a previous cesarean section and a need for delivery, induction of labor with a balloon catheter does not result in a significant increase in adverse maternal and neonatal outcomes as compared with planned cesarean section.