Preinduction cervical ripening in an outpatient setting: a prospective pilot study of a synthetic osmotic dilator compared with a double-balloon catheter.

Autor:	Koenigbauer JT; Department of Obstetrics, University Hospital Charité, Berlin, Germany., Kummer J; Department of Gynecology and Obstetrics, Vivantes Klinikum Im Friedrichshain, Berlin, Germany., Malan M; Faculty of Medicine, Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Kiel, Germany.; Department of Gynecology and Obstetrics, Asklepios Kliniken Barmbek, Wandsbek und Nord-Heidberg, Hamburg, Germany., Simon LM; Department of Gynecology and Obstetrics, Vivantes Klinikum Im Friedrichshain, Berlin, Germany., Hellmeyer L; Department of Gynecology and Obstetrics, Vivantes Klinikum Im Friedrichshain, Berlin, Germany., Kyvernitakis I; Department of Gynecology and Obstetrics, Asklepios Kliniken Barmbek, Wandsbek und Nord-Heidberg, Hamburg, Germany., Maul H; Department of Gynecology and Obstetrics, Asklepios Kliniken Barmbek, Wandsbek und Nord-Heidberg, Hamburg, Germany., Wohlmuth P; Asklepios Proresearch, Hamburg, Germany., Rath W; Faculty of Medicine, Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Kiel, Germany.
Jazyk:	angličtina
Zdroj:	Journal of perinatal medicine [J Perinat Med] 2024 Aug 21; Vol. 52 (9), pp. 946-954. Date of Electronic Publication: 2024 Aug 21 (Print Publication: 2024).
DOI:	10.1515/jpm-2024-0307
Abstrakt:	Objectives: To compare the effectiveness, safety and patient satisfaction of a double balloon catheter (DB) with a synthetic osmotic cervical dilator (OD) for pre-induction cervical ripening in an outpatient setting. Methods: This is a prospective, dual-center pilot study including 94 patients with an unripe cervix (Bishop Score <6) near term; 50 patients received the DB and 44 patients the OD. The primary outcomes were the difference in BishopScore (BS) and cervical shortening. Pain perception at insertion and during the cervical ripening period was evaluated by a visual analogue scale and patient satisfaction by a predefined questionnaire. Results: The use of DB was associated with a significantly higher increase in BS (median 3) compared to OD (median 2; p=0.002) and resulted in significantly greater cervical shortening (median -14 mm vs. -9 mm; p=0.003). There were no serious adverse events at placement of devices or during the cervical ripening. There were no significant differences in perinatal outcomes. Pain perception during cervical ripening was significantly higher (p<0.001), and patient satisfaction regarding sleep, relaxing time and performing desired daily activities were significantly lower in patients with DB compared to patients with OD (p<0.001). Conclusions: DB was superior to OD regarding cervical ripening based on BS and on sonographic measurement of the cervical length. Patients with OD experienced less pain during cervical ripening and were more satisfied with the method compared to patients with DB. (© 2024 Walter de Gruyter GmbH, Berlin/Boston.)
Databáze:	MEDLINE
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