Cervical Ripening Balloon for Induction of Labour in High Risk Pregnancies
- Author:
Hian Yan Voon
;
Angeline TY Wong
;
Moi Ling Ting
;
Haris Njoo Suharjono,
- Publication Type:Journal Article
- Keywords:
Cervical ripening balloon;
double balloon catheter;
mechanical;
induction of labour;
previous scar;
grandmultiparity
- MeSH:
Pregnant Women
- From:
The Medical Journal of Malaysia
2015;70(4):224-227
- CountryMalaysia
- Language:English
-
Abstract:
Background: The Cervical Ripening Balloon (CRB) is a novel
mechanical method for induction of labour (IOL), reducing
the risks of hyperstimulation associated with
pharmacological methods. However, there remains a paucity
of literature on its application in high risk mothers, who have
an elevated risk of uterine rupture, namely those with
previous scars and grandmultiparity.
Methodology: A retrospective study on IOL using the CRB in
women with previous caesarean section or grandmultiparity
between January 2014 and March 2015. All cases were
identified from the Sarawak General Hospital CRB request
registry. Individual admission notes were traced and data
extracted using a standardised proforma.
Results: The overall success rate of vaginal delivery after
IOL was 50%, although this increases to about two-thirds
when sub analysis was performed in women with previous
tested scars and the unscarred, grandmultiparous woman.
There was a significant change in Bishop score prior to
insertion and after removal of the CRB. The Bishop score
increased by a score of 3.2 (95% CI 2.8-3.6), which was
statistically significant (p<0.01) and occurred across both
subgroups, not limited to the grandmultipara. There were no
cases of hyperstimulation but one case of intrapartum fever
and scar dehiscence each (1.4%). Notably, there were two
cases of change in lie/presentation after CRB insertion.
Conclusion: CRB adds to the obstetricians’ armamentarium
and appears to provide a reasonable alternative for the IOL
in women at high risk of uterine rupture. Rates of
hyperstimulation, maternal infection and scar dehiscence
are low and hence appeals to the user.
- Full text:P020150908393948401644.pdf
