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Induction of labor methods in isolated term oligohydramnios
Eyal Krispin1,2, Tal Netser3,4, Avital Wertheimer3,4
1Rabin Medical Center, Helen Schneider Hospital for Women, 39 Zabotinski St, 4941492, Petach Tikva, Israel. eyalkrispin@gmail.com.
Archives of Gynecology and Obstetrics
|February 8, 2019
Summary
For term isolated oligohydramnios, prostaglandins were more effective than extra-amniotic balloon catheters for cervical ripening and vaginal delivery. Prostaglandin induction also resulted in fewer neonatal intensive care unit admissions.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
Background:
- Term isolated oligohydramnios presents a clinical challenge for labor induction.
- Choosing the optimal method for labor induction is crucial for maternal and neonatal outcomes.
Purpose of the Study:
- To compare pregnancy outcomes between prostaglandins and extra-amniotic balloon catheter for labor induction in cases of term isolated oligohydramnios.
- To evaluate the efficacy and safety of different labor induction methods in this specific obstetric condition.
Main Methods:
- Retrospective cohort study (2007-2016) of women with term isolated oligohydramnios.
- Comparison of induction using vaginal prostaglandins E2 versus extra-amniotic balloon catheter.
- Primary outcomes: successful cervical ripening (Bishop score ≥ 8) and vaginal delivery rate. Secondary outcomes: neonatal adverse events.
Main Results:
- Prostaglandins group (n=454) showed higher cervical ripening success (89.4% vs. 76.79%, p=0.006) and vaginal delivery rates (77.53% vs. 48.21%, p<0.0001) compared to the balloon catheter group (n=56).
- Prostaglandin induction remained superior for vaginal delivery after adjusting for confounders (aOR 3.470).
- Neonates in the balloon catheter group had higher NICU admission rates (14.55% vs. 3.39%, p=0.002).
Conclusions:
- Both prostaglandins and extra-amniotic balloon catheters are viable options for inducing labor in term isolated oligohydramnios.
- Prostaglandins demonstrated superiority in achieving cervical ripening and facilitating vaginal delivery.
- Prostaglandin use was associated with better neonatal outcomes, indicated by lower NICU admission rates.
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