Comparaison rétrospective de l’efficacité du ballonnet extra-amniotique à la dinoprostone dans la maturation cervicale

Abstract

ObjectiveTo compare the effectiveness and the safety of cervical ripening between two methods: the Cook double balloon catheter and the dinoprostone pessary (Propess 10mg). MethodsWe performed a retrospective comparative study in a French maternity. We analyzed 404 women with induction of labour after 37 gestational weeks, with singleton cephalic live fetus, unscarred uterus, unruptured membranes, and Bishop score<6. The primary endpoint was the time between the start of the ripening and the delivery. Secondary endpoints include effectiveness and safety outcomes of the methods. ResultsCompared to dinoprostone pessary, the balloon catheter was associated with a longer time to delivery (34.4±16.5 vs 25.5±15.3h; P<0.001). This difference is found in both primiparous and multiparous women. Balloon catheter is also associated with a smaller improvement of the Bishop score (2.5±2.1 vs 4.2±2.9 Bishop's points; P<0.001) and more failure to achieve delivery in 24h (32.3% vs 56.7%; P<0.001). There was no difference in mother and fetal safety. ConclusionIn this retrospective study, cervical ripening using balloon catheter seems to lengthen the induction of labour. No difference in safety outcomes with dinoprostone was found.