Safety of the balloon catheter for cervical ripening in outpatient care: complications during the period from insertion to expulsion of a balloon catheter in the process of labour induction: a systematic review

Abstract

Balloon catheter for cervical ripening appears to be safe enough to evaluate its use in the outpatient setting.

Induction of labour using prostaglandin E2 as an inpatient versus balloon catheter as an outpatient: a multicentre randomised controlled trial

“…Level‐1 evidence already affirms the safety of balloon IOL, and our study adds weight to these findings. There are however a relative paucity of prospective trials of outpatient cervical priming using balloon catheters . Our results would support outpatient balloon cervical priming for nulliparous women undergoing IOL for low‐risk indications, but more data are needed to monitor the safety of this approach.…”

Affordable and low‐maintenance obstetric devices

“…However, a higher rate of uterine rupture was recorded with the Foley catheter balloon, when compared with spontaneous labor (odds ratio 2.45; 95% confidence interval 1.34–4.47), which implies a need for additional maternal and fetal monitoring in these cases. Complication rates are low when the Foley catheter balloon is used in primiparous women in an outpatient setting . These complications include pain (0.26%), balloon displacement (0.07%), vaginal bleeding (0.07%), unintended amniotomy (0.04%), and non‐reassuring FHR (0.01%) …”

“…Complication rates are low when the Foley catheter balloon is used in primiparous women in an outpatient setting. 7 These complications include pain (0.26%), balloon displacement (0.07%), vaginal bleeding (0.07%), unintended amniotomy (0.04%), and non-reassuring FHR (0.01%). 7 The Foley catheter balloon can therefore be considered an effective and low-cost option for labor induction in women with an unfavorable cervix.…”

“…7 These complications include pain (0.26%), balloon displacement (0.07%), vaginal bleeding (0.07%), unintended amniotomy (0.04%), and non-reassuring FHR (0.01%). 7 The Foley catheter balloon can therefore be considered an effective and low-cost option for labor induction in women with an unfavorable cervix. This method has been demonstrated to be safe among primiparous women, even in outpatient settings, and can also be used for women with one previous cesarean delivery, provided that adequate maternal and fetal surveillance is available.…”

Current Resources for Evidence‐Based Practice, November/December 2018

“…Diederen and colleagues recently published a systematic review on the safety of outpatient cervical ripening using transcervical catheters for labor induction. Although most of the labors they analyzed in this review were for women who were inpatients, they focused on adverse events that occurred between catheter insertion and expulsion: the time period when women would be at home during outpatient cervical ripening procedures.…”