Objective
We sought to compare the efficacy of a double-balloon transcervical catheter to that
of a prostaglandin (PG) vaginal insert among women undergoing labor induction.
Study Design
In all, 210 women with a Bishop score ≤6 were assigned randomly to cervical ripening
with either a double-balloon device or a PGE2 sustained-release vaginal insert. Primary
outcome was vaginal delivery within 24 hours.
Results
The proportion of women who achieved vaginal delivery in 24 hours was higher in the
double-balloon group than in the PGE2 group (68.6% vs 49.5%; odds ratio, 2.22; 95%
confidence interval, 1.26–3.91). There was no difference in cesarean delivery rates
(23.8% vs 26.2%; odds ratio, 0.88; 95% confidence interval, 0.47–1.65). Oxytocin and
epidural analgesia were administered more frequently when a double-balloon device
was used. Uterine tachysystole or hypertonus occurred more frequently in the PGE2
arm (9.7% vs 0%, P = .0007).
Conclusion
The use of a double-balloon catheter for cervical ripening is associated with a higher
rate of vaginal birth within 24 hours compared with a PGE2 vaginal insert.
Key words
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Article Info
Publication History
Published online: June 04, 2012
Accepted:
May 24,
2012
Received in revised form:
April 15,
2012
Received:
February 1,
2012
Footnotes
The authors report no conflict of interest.
Cite this article as: Cromi A, Ghezzi F, Uccella S, et al. A randomized trial of preinduction cervical ripening: dinoprostone vaginal insert versus double-balloon catheter. Am J Obstet Gynecol 2012;207:125.e1-7.
Identification
Copyright
© 2012 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
