Déborah Secchi1, Julia Albéric2, Sophie Gobillot2, Adrien Ghenassia3, Matthieu Roustit4, Céline Chauleur1,5, Pascale Hoffmann2,6, Tiphaine Raia-Barjat7,8. 1. Department of Gynecology and Obstetrics, Centre Hospitalier Universitaire de Saint-Étienne, 42055, Saint-Étienne, France. 2. Service Obstétrique, Centre Hospitalo-Universitaire Grenoble Alpes, CS 10217, 38043, Grenoble, France. 3. Département d'information médicale, Centre Hospitalier Régional Universitaire de Lille, 2, avenue Oscar Lambret, 59037, Lille, France. 4. Centre Hospitalo-Universitaire Grenoble Alpes, Pharmacologie fondamentale, pharmacologie clinique et addictologie, CS 10217, 38043, Grenoble, France. 5. INSERM U1059 Sainbiose, Université Jean Monnet, Saint-Étienne, France. 6. Université Grenoble Alpes, CS 40700, 38058, Grenoble, France. 7. Department of Gynecology and Obstetrics, Centre Hospitalier Universitaire de Saint-Étienne, 42055, Saint-Étienne, France. tiphaine.barjat@chu-st-etienne.fr. 8. INSERM U1059 Sainbiose, Université Jean Monnet, Saint-Étienne, France. tiphaine.barjat@chu-st-etienne.fr.
Abstract
PURPOSE: To compare the rate of vaginal birth between double-balloon catheter and oxytocin alone for induction of labor in women with one previous cesarean section and an unfavorable cervix. MATERIALS AND METHODS: A retrospective and observational study was conducted from 2013 to 2017, at the Saint-Etienne University Hospital where women received induction with a double-balloon catheter for 12 h and at the Grenoble Alpes University Hospital where women received induction with a low-dose oxytocin infusion. Primary outcome was the rate of vaginal birth. RESULTS: Out of 1920 women eligible for attempting a vaginal birth after one previous cesarean section, 501 had a labor induction. Among women with an unfavorable cervix, 160 received a double-balloon catheter in Saint Etienne and 152 received oxytocin alone in Grenoble. The vaginal birth rate was higher in the double-balloon catheter group (61% versus 47% in the oxytocin group). An induction of labor with oxytocin alone reduced chances of vaginal birth (aOR 0.38 CI-95% [0.22-0.66]) compared to cervical ripening with double-balloon catheter. The perinatal morbidity was similar in the two groups. There was, however, 3.9% uterine rupture in the oxytocin group versus 0.6% in the double-balloon group (p = 0.11). CONCLUSION: For induction of labor in women with one previous cesarean section and with unfavorable cervix, cervical ripening with a double-balloon catheter increases the rate of vaginal birth without increased risk of uterine rupture.
PURPOSE: To compare the rate of vaginal birth between double-balloon catheter and oxytocin alone for induction of labor in women with one previous cesarean section and an unfavorable cervix. MATERIALS AND METHODS: A retrospective and observational study was conducted from 2013 to 2017, at the Saint-Etienne University Hospital where women received induction with a double-balloon catheter for 12 h and at the Grenoble Alpes University Hospital where women received induction with a low-dose oxytocin infusion. Primary outcome was the rate of vaginal birth. RESULTS: Out of 1920 women eligible for attempting a vaginal birth after one previous cesarean section, 501 had a labor induction. Among women with an unfavorable cervix, 160 received a double-balloon catheter in Saint Etienne and 152 received oxytocin alone in Grenoble. The vaginal birth rate was higher in the double-balloon catheter group (61% versus 47% in the oxytocin group). An induction of labor with oxytocin alone reduced chances of vaginal birth (aOR 0.38 CI-95% [0.22-0.66]) compared to cervical ripening with double-balloon catheter. The perinatal morbidity was similar in the two groups. There was, however, 3.9% uterine rupture in the oxytocin group versus 0.6% in the double-balloon group (p = 0.11). CONCLUSION: For induction of labor in women with one previous cesarean section and with unfavorable cervix, cervical ripening with a double-balloon catheter increases the rate of vaginal birth without increased risk of uterine rupture.
Authors: C Dupont; M Carayol; C Le Ray; C Barasinski; R Beranger; A Burguet; A Chantry; C Chiesa; B Coulm; A Evrard; C Fischer; L Gaucher; C Guillou; F Leroy; E Phan; A Rousseau; V Tessier; F Vendittelli; C Deneux-Tharaux; D Riethmuller Journal: Gynecol Obstet Fertil Senol Date: 2017-01-26