Comparaison des prostaglandines vaginales au misoprostol oral en 2e ligne de maturation cervicale après recours à un ballonnet de dilatation cervicale

Abstract

ObjectiveTo compare vaginal prostaglandins with oral misoprostol as a second line of cervical ripening after using a cervical balloon catheter. Material and methodsThis is a retrospective monocentric study (Lille, France), according to a “before”/“after” design. The inclusion criteria were a singleton pregnancy, with a fetus in cephalic presentation, a term >37 WA, with a cervix having a Bishop score lower than 6 after a first line of maturation by cervical balloon catheter. Two groups were formed: “before” corresponding to the continuation of maturation by vaginal prostaglandins, from March 2019 to November 2019, and “after”: corresponding to the continuation of maturation by oral misoprostol, from June 2020 to December 2020. The primary outcome was vaginal delivery rate. ResultsOne hundred women were included in each group. The rate of vaginal delivery was similar between the 2 groups (76% vs 81%, p=0.39), as were the times between the start of induction and the birth and between the start of induction and the transition to birth room. There was no difference in the indication for caesarean section, with in particular an identical rate of caesarean sections for induction failure (p=0.52). Subgroup analysis in obese women showed a significantly higher rate of vaginal delivery in the “after” group (OR=4.17;95% CI [1.02;17.07]). ConclusionThe vaginal delivery rate is similar when using vaginal prostaglandins or oral misoprostol as second line cervical ripening after use of a cervical balloon catheter.