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Published on: January 23, 2019
Predictive factors for successful cervical ripening using a double-balloon catheter after previous cesarean delivery
Mathilde Vital1, Joséphine Grange1, Aurélie Le Thuaut2
1Department of Obstetrics and Gynecology, Centre Hospitalier Departemental, La Roche-sur-Yon, France.
Objective:
To identify predictors of successful cervical ripening using double-balloon catheter (DBC) for labor induction among women with previous cesarean delivery (PCD) and unfavorable cervix at term.
Methods:
The present prospective observational study was conducted among women who underwent cervical ripening with DBC at a French tertiary care hospital between January 1, 2014, and December 31, 2017. Inclusion criteria were PCD; singleton term fetus; cephalic presentation; and unfavorable cervix (Bishop score <6). Indications for DBC were gestational diabetes mellitus, intrahepatic cholestasis of pregnancy, pre-eclampsia, prolonged pregnancy, fetal growth restriction, or prenatal suspicion of macrosomia. The primary outcome was Bishop score of at least six after DBC removal.
Results:
Among the 105 patients included, the initial Bishop score was 2.5 ± 1.5; successful cervical ripening occurred among 74 (70.5%) women; and vaginal delivery occurred among 46 (43.8%). The mean time from DBC insertion to delivery was 19.3 ± 6.7 hours. No adverse events were observed. Predictors of successful cervical ripening were initial Bishop score of at least three (adjusted odds ratio [aOR] 12.74, 95% confidence interval [CI] 2.78-58.47); PCD during labor (aOR 4.38, 95% CI 1.10-17.45); and internal cervical os open (aOR 4.94, 95% CI 1.44-17.01).
Conclusion:
Several factors were found to predict successful cervical ripening using DBC.
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