Double-balloon catheter vs. dinoprostone vaginal insert for induction of labor with an unfavorable cervix

Abstract

Purpose: To compare a double-balloon catheter and dinoprostone vaginal insert for induction of labor with an unfavorable cervix.

Methods: Patients with a Bishop score of ≤6 requiring labor induction at term received either a double-balloon catheter or a dinoprostone vaginal insert. The primary outcome was vaginal delivery rate within 24 h, and the secondary outcome was cesarean section rate.

Results: A total of 155 women were included; 76 received induction with a double-balloon catheter and 79 with the dinoprostone vaginal insert. The groups were similar with respect to maternal age, body mass index, gravidity, parity, baseline Bishop score, and indications for induction. Gestational age at induction was similar between the groups (double balloon 40.52 ± 0.86 weeks; dinoprostone 40.60 ± 0.79 weeks, P = 0.516). There was no difference in the vaginal delivery rate within 24 h (50 vs. 53.2 %, P = 0.694) or the cesarean section rate (39.5 vs. 31.6 %, P = 0.185) between the groups. More patients in the double-balloon catheter group required oxytocin administration than in the dinoprostone group (75 vs. 31.65 %, respectively, P < 0.001), but uterine hyperstimulation was less frequent in the double-balloon catheter group (0 vs. 10.1 %, respectively, P = 0.007). Neonatal outcomes were similar between the groups.

Conclusion: Double-balloon catheter and dinoprostone vaginal insert are associated with similar vaginal delivery and cesarean section rates and neonatal outcomes.