Mechanical methods for induction of labour

Vaan, Marieke DT de; Eikelder, Mieke LG ten; Jozwiak, Marta; Palmer, Kirsten; Davies‐Tuck, Miranda; Bloemenkamp, Kitty W. M.; Mol, Ben Willem J.; Boulvain, Michel

doi:10.1002/14651858.cd001233.pub4

Cited by 7 publications

(5 citation statements)

References 241 publications

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“… 9 , 10 , 11 , 12 Most studies on outpatient IOL use Foley catheters, although low‐dose oral misoprostol is considered to be a safe IOL method, with fewer cesarean sections and a comparable risk of other complications compared with Foley catheter. 26 In the two published papers on outpatient IOL using oral misoprostol, few adverse events were seen, but the studies were underpowered for safety outcomes. 13 , 14 …”

Section: Discussionmentioning

confidence: 99%

Outpatient labor induction—Exploring future potential by assessing eligibility in a historical cohort

Marsdal,

Sørbye,

Bernitz

et al. 2024

Acta Obstet Gynecol Scand

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IntroductionLabor induction rates have increased over the last decades, and in many high‐income countries, more than one in four labors are induced. Outpatient management of labor induction has been suggested in low‐risk pregnancies to improve women's birth experiences while also promoting a more efficient use of healthcare resources. The primary aim of this paper was to assess the proportion of women in a historical cohort that would have been eligible for outpatient labor induction with oral misoprostol. Second, we wanted to report safety outcomes and assess efficacy outcomes for mothers and infants in pregnancies that met the criteria for outpatient care.Material and methodsCriteria for outpatient labor induction with oral misoprostol were applied to a historical cohort of women with induction of labor at two Norwegian tertiary hospitals in the period January 1, through July 31, 2021. The criteria included low‐risk women with an unscarred uterus expecting a healthy, singleton baby in cephalic position at term. The primary outcome was the proportion of women eligible for outpatient labor induction. Secondary outcomes included reasons for ineligibility and, for eligible women, safety and efficacy outcomes.ResultsOverall, 29.7% of the 1320 women who underwent labor induction in a singleton term pregnancy met the criteria for outpatient labor induction. We identified two serious adverse events that potentially could have occurred outside the hospital if the women had received outpatient care. The mean duration from initiation of labor induction to administration of the last misoprostol was 22.4 h. One in 14 multiparous women gave birth within 3 h after the last misoprostol dose.ConclusionsIn this historical cohort, three in ten women met the criteria for outpatient management of labor induction with oral misoprostol. Serious adverse events were rare. The average time span from the initiation of labor induction to the last misoprostol was nearly 24 h. This suggests a potential for low‐risk women with an induced labor to spend a substantial period of time at home before labor onset. However, larger studies testing or evaluating labor induction with oral misoprostol as an outpatient procedure are needed to draw conclusions.

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Section: Discussionmentioning

confidence: 99%

Outpatient labor induction—Exploring future potential by assessing eligibility in a historical cohort

Marsdal,

Sørbye,

Bernitz

et al. 2024

Acta Obstet Gynecol Scand

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“…[27] DBC in labor carries a low risk of uterine hyperstimulation and leads to high maternal satisfaction. [13] Regarding the unfavorable cervix in the second-trimester, the duration of DBC ranges from 12 hours to 24 hours, which promotes cervical ripening. [10] In our study, only patient 3, who underwent UAE + DBC, experienced antenatal high fever (38.5 °C), albeit with no sepsis.…”

Section: Discussionmentioning

confidence: 99%

“…[9,10] Clinically, prophylactic uterine artery embolization (UAE) can be used to treat antenatal or intrapartum hemorrhage, [11,12] and double balloon catheter (DBC) is an effective method for cervical ripening. [13,14] Using DBC for cervical ripening followed by prophylactic UAE may be a promising strategy for second-trimester pregnancy termination in cases of complete placenta previa.…”

Section: Introductionmentioning

confidence: 99%

Clinical analysis of prophylactic uterine artery embolization combined with double balloon catheter for second-trimester pregnancy termination in cases of complete placenta previa: A retrospective study

Li,

Cheng,

Wen

et al. 2023

Medicine

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Complete placenta previa often causes significant bleeding in a short period during second-trimester pregnancy termination. This can destabilize the mother’s circulation, threatening her life. Furthermore, the condition is complicated by an immature cervix, making it a challenging clinical problem. The aim of this study was to investigate the effect of prophylactic uterine artery embolization (UAE) combined with double balloon catheter (DBC) deal with those cases. A total of 7 patients who underwent pregnancy termination in the second-trimester in Maternal and Child Health Hospital of Hubei Province between March 1st, 2021 and August 31st, 2023 were retrospectively analyzed in this study. All patients were diagnosed with complete placenta previa status and placenta accreta spectrum, and were treated with prophylactic UAE combined with DBC, and/or dilation and evacuation. All the patients received mifepristone, and 5 of them underwent medical termination with ethacridine lactate. Following prophylactic UAE combined with DBC, 6 patients underwent dilation and evacuation, which was monitored by ultrasound. And one patient experienced natural delivery of their fetus and placenta. Only one patient (patient 3) developed an intrapartum fever after prolonged duration of 18 hours from ethacridine to UAE and 56 hours from UAE to DBC. The amount of intrapartum hemorrhage ranged from 20 mL to 300 mL. The combined therapy of prophylactic UAE and DBC is a preferred option for patients with complete placenta previa undergoing second-trimester pregnancy termination. The use of dilation and evacuation may depend on the cervical condition, bleeding, or infection.

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“…Recent clinical trials have been conducted to compare the effectiveness and safety of the double‐balloon catheter with alternative methods, such as the Foley catheter, 4 dinoprostone, 5 and misoprostol, 6 in order to ascertain its superiority. Although the outcomes have not yielded a definitive consensus, mechanical methods appear to reduce the risk of uterine hyperstimulation 7 …”

Section: Introductionmentioning

confidence: 99%

“…Some groups have analyzed the time required to achieve effective cervical ripening with the use of the balloon, 8–10 the subsequent administration of misoprostol 7,11 and the possibility of outpatient 12 utilization when employing the balloon for cervical ripening. No studies analyzing the interval between balloon removal and oxytocin administration have so far been identified.…”

Section: Introductionmentioning

confidence: 99%

Interval between balloon removal and oxytocin administration in cervical ripening with double‐balloon in singleton pregnancies: An observational study

Sánchez‐Romero,

Ruiz‐Boluda,

Juan‐Pérez

et al. 2023

Intl J Gynecology & Obste

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ObjectiveTo analyze the influence of the resting interval after removal of a double‐balloon for cervical ripening and oxytocin administration on the time to onset of active labor in singleton pregnancies.MethodsA retrospective cohort study of women who required a cervical ripening with double‐balloon was conducted between January 2019 and December 2022. We collected data for cervical ripening balloon insertion and removal, oxytocin administration, suspicious or pathological cardiotocographic trace, mode of delivery, maternal and neonatal complications, neonatal outcomes. Proportional hazards model comparing resting interval between double‐balloon cervical ripening removal and oxytocin administration.ResultsA total of 403 singleton pregnancies were recruited and 213 pregnant women experienced a rest of 12 h between cervical balloon removal and oxytocin administration (resting group). Oxytocin was administered immediately after balloon removal in 190 women (non‐resting group). Median insertion‐to‐active labor interval and insertion‐to‐delivery interval were significantly shorter in the non‐resting group: 18.5 versus 24.0 h, HR 2.59 (CI 95%: 1.97–3.41) and 24.0 versus 29.0 h, HR 2.38 (CI 95%: 1.85–3.05) respectively. Bishop score change and mode of delivery between were similar in both groups. No differences in maternal nor neonatal complications between both groups were found.ConclusionsOxytocin administration immediately after removal of a double‐balloon for cervical ripening compared with 12 h delayed interval resulted in a shortened time from insertion to active labor onset and to delivery interval without increasing maternal or neonatal adverse outcomes.

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Mechanical methods for induction of labour

Abstract: Analysis 39.4. Comparison 39 Any mechanical method and oxytocin versus low dose misoprostol alone: all women (not prespecified), Outcome 4 Serious neonatal morbidity/perinatal death.

Cited by 7 publications

References 241 publications

Outpatient labor induction—Exploring future potential by assessing eligibility in a historical cohort

Outpatient labor induction—Exploring future potential by assessing eligibility in a historical cohort

Clinical analysis of prophylactic uterine artery embolization combined with double balloon catheter for second-trimester pregnancy termination in cases of complete placenta previa: A retrospective study

Interval between balloon removal and oxytocin administration in cervical ripening with double‐balloon in singleton pregnancies: An observational study

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