Setting of Induction of Labour with Double-Balloon Catheter in Low-risk Pregnancies: Outpatient Versus Inpatient

Induction of labour is one of the most frequently performed obstetric procedures. This analysis aimed to assess maternal and neonatal outcomes after labour induction with a double-balloon catheter in an outpatient versus inpatient setting in low-risk term pregnancies.

In this retrospective cohort study, 1010 women with singleton, low-risk term pregnancies undergoing labour induction with a double-balloon catheter were analysed. Of these, 394 received outpatient and 616 inpatient cervical ripening. The primary outcome was the caesarean section rate; secondary outcomes included the induction-to-delivery interval, vaginal delivery within 24 hours and neonatal parameters.

Delivery modes were comparable between groups (p = 0.5524), but vaginal delivery within 24 hours occurred less frequently in the outpatient group (25.2% vs. 32.9%, p = 0.0201). Neonatal outcomes were significantly better in the outpatient cohort, with lower rates of arterial umbilical cord pH < 7.10 (2.0% vs. 5.5%, p = 0.0067) and NICU admissions (6.9% vs. 15.1%, p < 0.0001). Multiple logistic regression analysis identified nulliparity (OR = 10.545), maternal age (OR = 1.076), and birth weight (OR = 1.733) as significant predictors for caesarean section. Failure to achieve vaginal delivery within 24 hours was associated with higher BMI (OR = 1.080), nulliparity (OR = 4.191), and fetal macrosomia (OR = 3.675), while labour onset by balloon catheter alone reduced this risk (OR = 0.149). Outpatient induction was associated with a lower risk of arterial pH < 7.10 (OR = 0.352, p = 0.0088).

Outpatient cervical ripening with a double-balloon catheter is a safe and effective alternative to inpatient induction in low-risk term pregnancies, with comparable delivery outcomes and potential neonatal benefits.