Double balloon device compared to oxytocin for induction of labour after previous caesarean section

Abstract

Objective: To assess cervical changes, duration of oxytocin infusion, mode of delivery and complications after cervical ripening using a double balloon device in women with a previous caesarean section. Methods: Longitudinal study including 80 women with a previous caesarean section, no previous vaginal delivery and an unfavourable cervix (Bishop score < 4). Two groups were established: a double balloon device was used with 32 women (exposed) and not with the others (non-exposed) (48). Statistical analysis was performed by comparing means (Student's t-test and Welch's test or paired Student's t-tests), or by comparing proportions (Chi square or Fisher's tests). Results: The mean number of hours of oxytocin infusion was statistically significantly higher in the nonexposed group (14.09 ± 6.05 vs 9.78 ± 3.95; p < 0.001), and in the exposed group the Bishop score increased after removing the double balloon device (3.22 ± 2.03 vs 1.16 ± 1.30; p < 0.01). There were no significant differences in the mode of delivery, rates of intrapartum fever or chorioamnionitis. Conclusion: The double balloon device for cervical ripening prior to induction with oxytocin in women with a previous caesarean section improves Bishop scores without increasing the rates of complications and decreasing the time for which oxytocin is required.

Double balloon catheter for induction of labour in Chinese women with previous caesarean section: one-year experience and literature review

“…Table 4 summarises the findings from some of the studies [8][9][10][11] including the current study. Most of the studies showed significant improvement in Bishop score after using the device and a favourable cervix was achieved in 75% to 85% of cases.…”

“…A second potential reason for better outcomes in our study would lie in the differences in inclusion criteria. Some studies had excluded women with previous vaginal delivery, 10 a factor known to be associated with successful VBAC. A third reason could have been differences in ethnicity.…”

Predictive factors for successful cervical ripening using a double‐balloon catheter after previous cesarean delivery

“…Eight studies [16][17][18][19][20][21][22][23] have specifically reported on the use of DBC for cervical ripening among women with PCD and an unfavorable cervix. Table 4 compares the findings of these investigations with those of the present study.…”

MEchanical DIlatation of the Cervix­­ in a Scarred uterus (MEDICS): the study protocol of a randomised controlled trial comparing a single cervical catheter balloon and prostaglandin PGE2 for cervical ripening and labour induction following caesarean delivery

“…In women with an unscarred uterus, mechanical induction demonstrates a lower incidence of uterine hyperstimulation and similar CSR compared with locally applied prostaglandins 34 38 41–47. Similarly, women with a previous CS induced with FCB showed no differences in uterine scar rupture rates when compared with spontaneous labour or IOL with amniotomy or oxytocin 48–53…”