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[Comparison of Methods for Cervical Ripening for Labor Induction for Fetal Indication: Mechanical vs.
Gal Bachar1, Nidaa Nassar2, Hiba Abu-Rass3
1Department of Obstetrics and Gynecology, Rambam Health Care Campus, Haifa, Israel, Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
For labor induction in nulliparous women with fetal indications, both prostaglandin E2 (PGE2) and cervical ripening balloon (CRB) are equally effective. However, PGE2 shows a lower risk of maternal complications like chorioamnionitis and OASIS.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Reproductive Medicine
Background:
- Cervical ripening methods for labor induction are debated.
- Effective methods are crucial for fetal well-being indications.
Purpose of the Study:
- To compare the efficacy and safety of prostaglandin E2 (PGE2) versus cervical ripening balloon (CRB) for labor induction in nulliparous women with fetal indications.
- To evaluate maternal and neonatal outcomes associated with each method.
Main Methods:
- Retrospective cohort study (2010-2021) at a tertiary center.
- Included 716 nulliparous women with Bishop score ≤6 and vertex presentation undergoing induction for fetal well-being.
- Compared outcomes between PGE2 and CRB groups.
Main Results:
- No significant difference in time to delivery or mode of delivery between PGE2 and CRB.
- PGE2 group had lower rates of chorioamnionitis (3.5% vs. 7.1%) and obstetric anal sphincter injury (OASIS) (2.2% vs. 5.1%).
- Neonatal outcomes were similar between the groups.
Conclusions:
- Both PGE2 and CRB are similarly effective for labor induction in nulliparous women with fetal indications.
- PGE2 offers a better maternal safety profile with reduced risks of chorioamnionitis and OASIS.
- PGE2 may be preferred due to its lower maternal complication rates.
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