Safety and effectiveness of labour induction after caesarean section using balloon catheter or oxytocin.

Radan, Anda-Petronela; Amylidi-Mohr, Sofia; Mosimann, Beatrice; Simillion, Cedric André Marie; Raio, Luigi; Müller, Martin; Surbek, Daniel (2017). Safety and effectiveness of labour induction after caesarean section using balloon catheter or oxytocin. Swiss medical weekly, 147, w14532. EMH Schweizerischer Ärzteverlag 10.4414/smw.2017.14532

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AIMS OF THE STUDY Induction of labour after previous caesarean section (CS) is a challenge for obstetricians due to the increased risk of uterine rupture. Common methods for labour induction are balloon catheters and oxytocin as they are considered safe. However, the effectiveness remains unclear as currently available data are limited. Therefore, we aimed to determine safety and effectiveness of balloon catheter or oxytocin for labour induction after CS. METHODS We included 179 consecutive women with a previous CS and labour induction in this retrospective study. We performed labour induction using a balloon catheter in case of a Bishop score of <6 and intact membranes, or oxytocin in the case of a Bishop score of >6 and/or premature rupture of membranes. The primary outcome was the rate of successful vaginal deliveries. We adjusted for multiple factors that may have impacted on the rate of vaginal delivery as well. The secondary outcomes were the rate of maternal and neonatal morbidities. RESULTS We detected a vaginal delivery success rate of 45.8% in the catheter and of 63.9% in the oxytocin group. We identified previous vaginal birth as an independent predictive factor for successful vaginal delivery in both groups. Induction using oxytocin was a negative predictive factor for neonatal admissions. Multivariate analysis showed that post-term pregnancy decreased the likelihood of vaginal delivery. We did not detect any factors predicting uterine rupture or uterine dehiscence, which occurred with similar frequency in both groups. Finally, the neonatal admission rate was less likely with higher gestational age and oxytocin as an induction method, whereas previous vaginal birth increased the risk. CONCLUSIONS Our study indicates that induction of labour with balloon catheter or oxytocin seems to be safe in women with previous CS. Labour induction using a balloon catheter in women with previous CS and unfavourable cervix has a disappointingly low success rate. We identified factors influencing vaginal delivery success rates. Women with previous CS and indications for labour induction should be informed about vaginal birth success rates and the alternative of elective repeat CS needs to be discussed.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR)
04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Gynaecology

UniBE Contributor:

Radan, Anda-Petronela; Amylidi, Sofia Kalypso; Mosimann, Beatrice; Simillion, Cedric André Marie; Raio, Luigi; Müller, Martin and Surbek, Daniel

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1424-7860

Publisher:

EMH Schweizerischer Ärzteverlag

Language:

English

Submitter:

Monika Zehr

Date Deposited:

07 Mar 2018 14:43

Last Modified:

26 Oct 2019 13:28

Publisher DOI:

10.4414/smw.2017.14532

PubMed ID:

29120029

BORIS DOI:

10.7892/boris.110885

URI:

https://boris.unibe.ch/id/eprint/110885

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