Cervical ripening using a double balloon device (Cook's balloon): our experience

Abstract

Objective evaluate the efficacy and outcomes of the double balloon device (Cook's balloon) in inducing women into labour in whom prostaglandin has failed or who have had previous cesarean section. Method Data was collected prospectively. Women who satisfied the inclusion criteria were assessed and their bishop scores recorded prior to insertion of Cook's Balloon. The bishop score was also recorded at the time of removal of the balloon and an amniotomy performed if the cervix was favourable. Syntocinon was used as required, and the mode of delivery was subsequently recorded. Results 68 women met the inclusion criteria. In 37 (54%) women the indication was failed induction with prostaglandins, using up to 9mg of prostin, while Cook's balloon was the primary method for induction of labour in 30 (44%) women, 1 was unrecorded. Vaginal delivery was achieved in 17 (46%) women and 13 (43%) women, respectively. The mean change in bishop score was 4. Conclusion Although prostaglandins are still the preferred method for induction of labour in the UK; we believe that the double balloon (Cook's balloon) can help avoid a caesarean section when they fail. It also significantly increases the Bishops score leading to a shorter duration in labour and a lower cesarean section rate.