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[Double-balloon device and intravaginal dinoprostone for cervical ripening in women with unfavourable cervix]
M Letailleur1, N Mathieu1, G Dietrich1
1Service de gynécologie-obstétrique, pavillon Mère-Enfants, hôpital Charles-Nicolle, CHU de Rouen, 1, rue de Germont, 76031 Rouen cedex, France.
Objectives:
To compare the efficiency of a double cervical ripening (mechanical agent and dinoprostone) to a dinoprostone-only ripening in women with an unfavourable cervix.
Methods:
In a retrospective study from January 2008 to October 2013, 96 patients were included with the following criteria: pregnancies over 37 weeks, singleton, vertex presentation, medical indication for induction of labor, no premature rupture of membranes and very unfavourable cervix (Bishop score ≤ 3). Patients were classified into 2 groups: intravaginal dinoprostone for 24h (prostaglandin group, n=38) and double-balloon device for 12h followed by intravaginal dinoprostone for 24h (balloon+prostaglandin group, n=58).
Results:
There was no difference in vaginal delivery rates between the 2 groups (balloon+prostaglandin group 51.7%, prostaglandin group 50%, P=0.87). The Bishop score after cervical ripening was significantly higher in the balloon+prostaglandin group (4.4 versus 2.4, P<0.0001), but the interval between the induction and the delivery was longer (33.6h versus 24.9h, P=0.0044). There was no significant difference for maternal and neonatal complications.
Conclusion:
A double cervical ripening (with mechanical agent and dinoprostone) allows the Bishop score to be improved without increasing the rate of vaginal delivery, for patients with a Bishop score ≤ 3.
