Abstract
Objective: To assess cervical changes, duration of oxytocin infusion, mode of delivery and complications after cervical ripening using a double balloon device in women with a previous caesarean section. Methods: Longitudinal study including 80 women with a previous caesarean section, no previous vaginal delivery and an unfavourable cervix (Bishop score
Highlights
In recent years, there have been upward trends in the rates of labour induction and percentages of caesarean sections [1]
It has been shown that the use of pharmacological methods (E2 prostanglandin and misoprostol) in a group of patients with previous caesarean section increased the risk of uterine rupture (2.4%), compared to spontaneous onset of labour (1%), so such methods are not recommended in these women [3]
A total of 75 women with previous caesarean section who were admitted to Donostia Hospital for induction between January 2005 and December 2008 were identified and their medical records reviewed: 27 women were excluded from the study, 16 because of premature rupture of membranes and 11 because they had a Bishop score ≥ 4 and/or a cervical dilation ≥ 2 cm, and 48 women were included in this group
Summary
There have been upward trends in the rates of labour induction and percentages of caesarean sections [1]. Some women in whom induction is indicated have an unfavourable cervix, and in these cases pharmacological and mechanical methods are used to achieve cervical ripening. It has been shown that the use of pharmacological methods (E2 prostanglandin and misoprostol) in a group of patients with previous caesarean section increased the risk of uterine rupture (2.4%), compared to spontaneous onset of labour (1%), so such methods are not recommended in these women [3]. It does seem to be clear, that the risk of uterine hyperstimulation is lower than with prostaglandins and that their use is not associated with a significant increase in the risk of uterine rupture compared to spontaneous delivery [5]. The objective of this study was to assess the effectiveness and safety of double balloon device for cervical ripening in women with a previous caesarean section and no previous vaginal deliveries
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