Conventional versus modified application of COOK Cervical Ripening Balloon for induction of labor at term: a randomized controlled trial

Abstract

Background This study aims to evaluate the efficacy and safety of the modified application of COOK Cervical Ripening Balloon (CCRB) for induction of labor (IOL) at term in primipara. Methods A total of 227 singleton full-term pregnancies with indications of IOL were enrolled and randomly divided into the control and study groups in our hospital from January 2021 to December 2021. In the control group, a conventional method was used. Both the uterine and vaginal balloons were filled to 80 mL and removed after 12 h. In the study group, a modified method was used. The uterine and vaginal balloons were filled to 120 mL and 40 mL respectively. Light traction was given to help CCRB to be discharged after 12 h placement. Oxytocin was administered in both groups after CCRB was discharged before labor starting. The improved Bishop scores, duration of labor, and spontaneous delivery rate were evaluated in the two groups. Results The improved Bishop scores in the study group were 3.06 ± 0.97 at 12 h placement of CCRB and 4.37 ± 0.87 when CCRB was discharged, which were significantly higher compared to the control group (2.52 ± 0.79, p < 0.05). Duration of the first stage of labor and the full labor in the study group were significantly shorter than those in the control group ((6.17 ± 2.85) h vs. (7.27 ± 2.90) h, p = 0.010; (7.07 ± 3.18) h vs. (8.09 ± 3.11) h, p = 0.028). No difference in spontaneous delivery rate between the two groups was observed. But the delivery rate within 24 h between the two groups was significantly different (79.79% vs. 55.91%, p < 0.05). For the cases with initial Bishop scores ≤ 3, the improved score was significantly increased, the first stage of labor and the full labor were significantly shorter in the study group than those in the control group (p < 0.05). Those results were not observed in cases with initial Bishop scores of 4–6. Conclusions The modified application of CCRB could benefit cervical ripening, shorten the duration of labor, especially for cases with poor cervical maturity, and improve the delivery rate within 24 h. Trial registration Retrospectively registered: ChiCTR2200058270. Registered 04/04/2022.

Effect of cervical Bishop score on induction of labor at term in primiparas using Foley catheter balloon: a retrospective study

“…In our study, the overall success rate of induction of labor was more than 96%, this was basically consistent with Wen C 's study [30] (97.8%). In a meta-analysis study [31], it was found that the total vaginal delivery rate of single balloon catheter was 78.8%.…”

“…However, most studies did not mention the effect of different cervical scores on catheter balloon induction of labor. In Wen C 's study [30], it was only found that patients with initial Bishop score ≤ 3 and patients with initial Bishop score of 4-6 had significant improvement in Bishop score after balloon Data were expressed as rate (%); 1 Chi-square promotion of cervical ripening, but the influence of other aspects was not mentioned. In our study, we found that there was no significant difference in the final methods of delivery between the two groups.…”

Cervical Balloon Induction in LDRP Unit: Effects on Maternal and Neonatal Outcomes for Primiparous Women

“…Both have been extensively studied and have shown to be safe and effective [10][11][12]. However, recent research has suggested that the double-balloon catheter may be a safer approach for patients [13][14][15]. The LDRP delivery model, which is gaining popularity in China for its emphasis on natural delivery, may not be suitable for pregnant women who are at a higher risk for complications.…”