Abstract
Objective:To compare the effectiveness and safety of oxytocin and a cervical ripening balloon in women with unfavorable cervices for inducing labor.Material and Methods:A total of eighty pregnant women between 37-41 gestational weeks having singleton pregnancies and intact membranes with unfavorable cervices were randomized into two groups, cervical ripening balloon (n=40) and oxytocin infusion (n=40). The primary outcomes were the labor time and the route of delivery. Secondary outcomes were the effect of parity on time of labor, and obstetric and perinatal outcomes.Results:The median time to delivery was 9.45 hours in cervical ripening balloon group and 13.2 hours in the oxytocin group in multiparous women. The differences were statistically significant (p<0.001). The median time until delivery was 11.48 hours in cervical ripening balloon group and 13.46 hours in the oxytocin group; the differences were statistically significant (p<0.001). Cesarean delivery ratios were similar in both groups (p=0.431).Conclusion:The results of the present study are promising for balloon use, especially in multiparous women. It is beneficial to support these data with wide ranging population-based studies.
Highlights
The mechanisms of birth and the initiating factors of labor are still obscure
We compared the effects of oxytocin and cervical ripening balloons in term pregnancies with unfavorable cervices
Oxytocin is known as the hormone that starts uterine contractions
Summary
The mechanisms of birth and the initiating factors of labor are still obscure. The main goal of obstetrics is the health of both the mother and the baby. Labor initiates spontaneously in a vast majority of pregnancies, induction of labor (IOL) may be needed in a wide variety of conditions including post-term pregnancies, preterm premature membrane rupture, preeclampsia, eclampsia, hemolysis, elevated liver enzyme levels, and low platelet levelsHELLP syndrome, fetal demise, maternal diabetes mellitus, fetal distress, maternal cholestasis, and chorioamnionitis. In such situations, an unfavorable uterine cervix is one of the major obstacles to successful IOL [1]. Nearly 50% of women with an indication of IOL have an unfavorable cervix with a Bishop score of less than six [2]
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