[Mechanical methods for cervical ripening in France: An evaluation of professional practices]

Abstract

Objective: Mechanical methods for cervical ripening are as effective as prostaglandins for the rate of vaginal delivery. Our aim was to study professional practices of mechanical cervical ripening in France.

Methods: A declarative survey was conducted among two groups of maternity units: a sample representative of French maternity units (group 1) and on the whole of type 3 maternity units (group 2). A questionnaire was emailed to physicians of these obstetric units between May and July 2014.

Results: Forty-three of the 104 units (41.3%) in the first group and 43 of the 64 units in the second group (67.2%) answered the questionnaire. Among these maternity units, mechanical methods were used respectively in 44.2 and 69.8% of the establishments. The two main devices used were the trans-cervical balloon catheter and the Foley catheter. The main indication for mechanical methods was induction of labor with prior caesarean. In case of induction of labor, a prior caesarean and a Bishop score < 7, in the first group, 46.6% of the maternity units did a caesarean, 32.3% performed an induction of labor with mechanical methods, 13.9% with oxytocin and 6.9% with prostaglandins. In the second group, 25.6% of maternity units performed a caesarean, 53.6% used mechanical methods, 9.3% used oxytocin and 11.6% used prostaglandins.

Conclusion: In France nearly half of the maternity units and nearly three-quarters of type 3 maternity units say they use mechanical cervical ripening, mainly used in case of prior caesarean.

Keywords: Ballonnet trans-cervical; Cervical ripening; Déclenchement du travail; Foley catheter; Induction of labor; Maturation cervicale; Mechanical methods; Méthodes mécaniques; Sonde de Foley; Trans-cervical balloon.