- Simultaneous use of cervical ripening balloon and oxytocin shortens time of induction of labor (IOL) in multiparous women without affecting maternal or neonatal morbidity.
Why this matters
- 1 out of 5 pregnant women will undergo IOL in the United States.
- IOL increases costs as a result of time spent in hospital.
- Patients who received simultaneous cervical ripening balloon and oxytocin were more likely to deliver within 24 hours (87.8% vs 73.3%; OR, 2.61; P=.02) compared with sequential cervical ripening balloon followed by oxytocin.
- There was no significant difference in rate of cesarean delivery, postpartum hemorrhage, chorioamnionitis, Apgar scores, or neonatal ICU admissions between groups.
- Randomized controlled trial.
- Women ≥34 weeks gestation, with prior spontaneous vaginal delivery, who had a plan for IOL and cervical examination ≤2 cm were included.
- Participants were randomly assigned into 2 groups: sequential cervical ripening balloon followed by oxytocin (n=90) vs simultaneous cervical ripening balloon and oxytocin (n=90).
- Primary outcome was delivery within 24 hours of balloon placement.
- Funding: Study funded intramurally.
- Only multiparous women included.
- Interventions could not be masked.