M Sarreau1, L Leufflen2, E Monceau2, D Tariel3, P Villemonteix4, O Morel2, F Pierre5. 1. Service de gynécologie-obstétrique et médecine de la reproduction, université de Poitiers, CHU de Poitiers, 2, rue de la Milétrie, 86000 Poitiers, France; Service de gynécologie-obstétrique, CHG Angoulême, rond point de Girac, 16000 Angoulême, France. Electronic address: meliesarreau@hotmail.com. 2. Maternité régionale universitaire de Nancy, pôle de la femme, université de Lorraine, Inserm U947 IADI, 54000 Nancy, France. 3. Service de gynécologie-obstétrique, CHG Angoulême, rond point de Girac, 16000 Angoulême, France. 4. Service de gynécologie-obstétrique, CHG Nord Deux-Sèvres, 79800 Bressuire, France. 5. Service de gynécologie-obstétrique et médecine de la reproduction, université de Poitiers, CHU de Poitiers, 2, rue de la Milétrie, 86000 Poitiers, France.
Abstract
OBJECTIVES: To evaluate safety and efficacy of balloon catheter for labor induction in women with previous cesarean section. MATERIAL AND METHODS: In a multicenter retrospective cohort study, 151 patients were included with the following criteria: pregnancy over 37 weeks, singleton, vertex presentation, previous caesarean section with unique transversal segmentary incision, medical indication for induction of labor, unfavorable cervix with Bishop score inferior to 7, no premature rupture of membranes. Balloon catheter used for cervix ripening, is inflated from 30 to 80 mL of sterile of NaCl and is left until 24 hours. RESULTS: Overall rate of vaginal delivery was 53.7% (81/151). Labor began before balloon catheter removal for 58 out of 151 (38.4%) with vaginal delivery for 75% (42/58). Best prognosis factors for vaginal delivery were spontaneous labor after balloon removal (P=0.004) and anterior vaginal delivery (P=0.03). Side effects were rare bleeding or PROM, but didn't prevent continuing ripening labor. Other morbidity consisted in two uterus ruptures (1.2%) without maternofetal incidence. CONCLUSION: Supracervical balloon is a safe and efficiency method for inducing labor on scarred uterus with unfavorable cervix with low side effects.
OBJECTIVES: To evaluate safety and efficacy of balloon catheter for labor induction in women with previous cesarean section. MATERIAL AND METHODS: In a multicenter retrospective cohort study, 151 patients were included with the following criteria: pregnancy over 37 weeks, singleton, vertex presentation, previous caesarean section with unique transversal segmentary incision, medical indication for induction of labor, unfavorable cervix with Bishop score inferior to 7, no premature rupture of membranes. Balloon catheter used for cervix ripening, is inflated from 30 to 80 mL of sterile of NaCl and is left until 24 hours. RESULTS: Overall rate of vaginal delivery was 53.7% (81/151). Labor began before balloon catheter removal for 58 out of 151 (38.4%) with vaginal delivery for 75% (42/58). Best prognosis factors for vaginal delivery were spontaneous labor after balloon removal (P=0.004) and anterior vaginal delivery (P=0.03). Side effects were rare bleeding or PROM, but didn't prevent continuing ripening labor. Other morbidity consisted in two uterus ruptures (1.2%) without maternofetal incidence. CONCLUSION: Supracervical balloon is a safe and efficiency method for inducing labor on scarred uterus with unfavorable cervix with low side effects.