Comparison between Vaginal Dinoprostone and Double-Balloon Catheter for Labor Induction in Low-Risk Pregnancies

Labor induction is commonly performed in high-risk pregnancies, but can also be beneficial in low-risk populations, as shown in the ARRIVE trial. This study aimed to compare the effectiveness and pregnancy outcomes of labor induction using vaginal dinoprostone and a double-balloon catheter in low-risk pregnant women.

A prospective comparative cohort study was conducted on 560 women with low-risk pregnancies at 39⁰⁄₇ to 40⁶⁄₇ weeks of gestation at Hanoi Obstetrics and Gynecology Hospital between January 7, 2021 and December 31, 2023. Among them, 285 women underwent labor induction with vaginal dinoprostone and 275 with a double-balloon catheter. Maternal and neonatal outcomes were compared between the two groups.

Among 560 women, vaginal delivery occurred in 58.6% with dinoprostone and 51.3% with the double-balloon catheter (crude RR 1.14, 95% CI 0.98-1.33). Adjusted and IPTW analyses yielded similar estimates (adjusted RR 1.14, p=0.06; IPTW RR 1.15, p=0.08). Dinoprostone was associated with more uterine hyperstimulation (2.5% vs 1.5%), whereas postpartum infection was more frequent with the double-balloon catheter (1.1% vs 0%); neither difference was statistically significant.

Both vaginal dinoprostone and the double-balloon catheter were effective and relatively safe methods for labor induction in low-risk pregnancies. No statistically significant differences were detected between vaginal dinoprostone and the double-balloon catheter.