Timing of sequential use of double-balloon catheter and oral misoprostol for induction of labor

Aim The best time to commence cervical ripening with a balloon catheter is unknown. The aim of this study was to evaluate whether application of a balloon catheter in the morning or in the evening is better when sequential prostaglandin application is planned. Methods This multicenter historical coh...

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Hauptverfasser: Kehl, Sven (VerfasserIn) , Weiß, Christel (VerfasserIn) , Sütterlin, Marc (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 19 September 2016
In: The journal of obstetrics and gynaecology research
Year: 2016, Jahrgang: 42, Heft: 11, Pages: 1495-1501
ISSN:1447-0756
DOI:10.1111/jog.13089
Online-Zugang:Verlag, Volltext: https://doi.org/10.1111/jog.13089
Verlag, Volltext: https://obgyn.onlinelibrary.wiley.com/doi/abs/10.1111/jog.13089
Volltext
Verfasserangaben:Sven Kehl, Lena Böhm, Christel Weiss, Jutta Heimrich, Ulf Dammer, Friederike Baier, Marc Sütterlin, Matthias W. Beckmann and Florian Faschingbauer

MARC

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520 |a Aim The best time to commence cervical ripening with a balloon catheter is unknown. The aim of this study was to evaluate whether application of a balloon catheter in the morning or in the evening is better when sequential prostaglandin application is planned. Methods This multicenter historical cohort study included 415 women with an unfavorable cervix undergoing labor induction at term. Labor was induced with a double-balloon catheter and the sequential use of oral misoprostol if necessary. The balloon catheter was placed in the morning group between 02:00-15:00 and in the evening group between 15:00-02:00. The primary outcome measure was the cesarean section rate. Secondary outcome measures included failed labor induction (no vaginal delivery within 72 h). Results The cesarean section rate did not differ between the groups (morning 26.9%, evening 24.3%; P = 0.5553); however, more women in the morning group did not deliver within 72 h (8.8% vs 3.1%; P = 0.0138). In nulliparous women, labor induction failed more often in the morning group (12% vs. 4%, P = 0.043). In parous women, the induction-to-delivery interval was longer in the morning group (1756 vs. 1349 min; P = 0.046), and there were fewer deliveries within 24 h (35% vs. 56%, P = 0.016). Conclusions When sequential use of a double-balloon catheter and oral misoprostol for labor induction is planned, the preferable time for catheter placement is in the evening. This resulted in fewer failed inductions in nulliparous women and a shorter induction-to-delivery interval and more deliveries within 24 h in parous women. 
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