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Archives of Gynecology and Obstetrics

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18-02-2023 | Misoprostol | Maternal-Fetal Medicine

Time from insertion to expulsion of cervical ripening balloon in preterm versus term inductions of labor

Authors: Lindsey A. Roth, Elana Kreiger-Benson, Steven Friedman, Dana R. Gossett, Lisa Shanahan

Published in: Archives of Gynecology and Obstetrics | Issue 2/2024

Abstract

Objective

Preterm induction of labor can be necessary for maternal and fetal wellbeing. Duration of cervical ripening balloon (CRB) use has been studied in only term inductions. Our study investigated duration of time in hours for CRB expulsion and vaginal delivery in preterm inductions of labor.

Methods

This was a single-institution retrospective cohort study of preterm (< 37 weeks) and term (≥ 37 weeks) inductions with CRB between 2010 and 2021. Cesarean deliveries were excluded. Primary outcome was insertion to expulsion time of CRB. Secondary outcomes included induction to delivery time, cervical dilation after expulsion, misoprostol, and Pitocin use. Institutional review board (IRB) approval was obtained prior to the study.

Results

Ninety-eight patients with vaginal delivery after preterm CRB use were identified and matched 1:1 on baseline characteristics (p > 0.05) to term patients with vaginal delivery after CRB use. Mean insertion to expulsion time was significantly shorter for term than preterm inductions (mean 7.2 ± 3.09 h versus 8.5 ± 3.38 h; p < 0.01). Mean induction to delivery time was significantly shorter for term than preterm inductions (18.4 ± 7.6 h versus 22.5 ± 9.01 h; p < 0.01). Increased use of misoprostol, Pitocin, and second CRB were noted among the preterm cohort. Among term patients, more CRB placement at start of induction and greater cervical dilation post-balloon were found in comparison to preterm patients.

Conclusion

Among patients undergoing preterm induction, longer insertion to expulsion time of CRB, longer induction to delivery time, and increased interventions should be expected. Different standards for labor management should be considered for achieving vaginal delivery in preterm inductions.

Centers for Disease Control and Prevention. Preterm Birth. Center for Disease Control and Prevention

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Title: Time from insertion to expulsion of cervical ripening balloon in preterm versus term inductions of labor
Authors: Lindsey A. Roth
Elana Kreiger-Benson
Steven Friedman
Dana R. Gossett
Lisa Shanahan
Publication date: 18-02-2023
Publisher: Springer Berlin Heidelberg
Keyword: Misoprostol
Published in: Archives of Gynecology and Obstetrics / Issue 2/2024
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-023-06961-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Time from insertion to expulsion of cervical ripening balloon in preterm versus term inductions of labor

Abstract

Objective

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

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