Induction of labour using balloon catheter and prostaglandin gel.

Background: The process of induction of labour (IOL) commonly involves cervical ripening, using mechanical or pharmacological methods. However, the optimum protocol of IOL remains undetermined.
Aims: To report the maternal, neonatal and process outcomes for women being induced with a balloon catheter or prostaglandin E2 gel (PGE2).
Materials and Methods: Matched retrospective cohort study of women requiring IOL at term with a modified Bishop's score (MBS) <7. Those who underwent cervical ripening with a double balloon catheter were matched 1:1 for parity, indication and MBS score to those using PGE2 gel. The primary outcome measure was mode of birth.
Results: After exclusions, data from 427 women induced with a balloon catheter were able to be matched to 427 women induced with PGE2 gel. Compared to women receiving PGE2 gel, those induced using a balloon catheter were more likely to have an unassisted vaginal birth (50.4% vs 42.9%; P = 0.028), a lower mean estimated blood loss (420 vs 481 mL; P = 0.028), a reduction in fetal acidaemia (2.4% vs 8.8%; P = 0.003) and a greater likelihood experiencing vaginal delivery within 24 h (33.7% vs 25.8%; P = 0.011).
Conclusion: Similar to findings in randomised controlled trials and meta-analyses of IOL methods, we observed more unassisted vaginal births, less blood loss, decreased fetal acidaemia, and a greater likelihood of vaginal delivery within 24 h, with use of balloon catheter as compared to PGE2 vaginal gel.
(© 2017 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.)