On the Safety of COOK Double Balloons to Promote Cervical Ripening in Pregnant Women With Group B Streptococcus Colonization

Abstract

Background: For pregnant women who develop complications during the third trimester of pregnancy, or who have not given birth naturally after more than 41 weeks of pregnancy, artificial induction of labor is needed in order to obtain a healthy outcome for both the mother and the child. The 2014 edition of the Guidelines for Promoting Cervical Maturation and Delivery in Late Pregnancy point out that the use of COOK cervical ripening balloons to mechanically dilate the cervix can be used in the third trimester to promote cervical ripening and labor induction [1]. The disadvantage is the risk of infection, premature rupture of membranes, and umbilical cord prolapse [2]. The safety of balloon induction for pregnant women colonized by group B streptococcus (GBS) is currently lacking in multi-center clinical research data. This article will study the safety of COOK double balloon induction in pregnant women colonized by GBS.Methods: A total of 1,681 pregnant women who used COOK double balloons for cervical ripening in Changsha Maternity and Child Health Hospital from September 2018 to September 2020 were selected as the research subjects, from which 125 cases with colonization of group B streptococcus in the reproductive tract were selected as the observation group. Pregnant women without group B streptococcus colonization (N = 1556) served as the control group. This study compares the two groups’ delivery methods, postpartum complications, and neonatal conditions. Results: The rate of transition to cesarean section in the observation group was slightly higher, and the difference was statistically significant (p = 0.049). The rate of postpartum hemorrhage was higher than that of the control group (p < 0.05). Although chorioamnionitis increased compared to the control group, the difference was not significant (p > 0.05). The comparison of newborn birth indicators between the two groups showed no statistically significant difference (p > 0.05). Conclusion: When pregnant women with colonization of group B streptococcus of the genital tract use the COOK double balloon to promote cervical ripening, the success rate of labor induction is high. Use of the balloon does not increase the cesarean section rate and the incidence of chorioamnionitis, nor does it increase the risk of neonatal infection. However, the risk of postpartum hemorrhage increases, and it is necessary to take active measures to reduce this risk.