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Balloon catheter use for cervical ripening in women with term pre-labor rupture of membranes; a five-year cohort study.

Research paper by Heidi H Kruit, Jenna J Tolvanen, Jasmin J Eriksson, Katariina K Place, Irmeli I Nupponen, Leena L Rahkonen

Indexed on: 04 Apr '20Published on: 04 Apr '20Published in: Acta Obstetricia et Gynecologica Scandinavica



Abstract

To investigate safety of balloon catheter for cervical ripening in women with term pre-labor rupture of membranes (PROM), and to compare the incidence of maternal and neonatal infections in women with PROM and women with intact membranes undergoing cervical ripening with a balloon catheter. This retrospective cohort study of 1923 women with term singleton pregnancy and an unfavorable cervix undergoing cervical ripening with a balloon catheter was conducted in Helsinki University Hospital between January 2014 and December 2018. For each case of PROM, two controls were assigned. The main outcome measures were the rates of maternal and neonatal infections. Statistical analyses were performed by SPSS. 641 (33.3%) women underwent labor induction following PROM and 1282 (66.6%) women with intact amniotic membranes. The rates of intrapartum infection (3.7% vs. 7.7%; p=0.001) and neonatal infection (1.7% vs. 3.8%; p=0.01) were not increased in women induced by balloon catheter following PROM. Intrapartum infections were associated with nulliparity (OR 3.3, 95% CI 1.6-6.5), history of previous cesarean section (OR 2.8, 95% CI 1.2-6.4), extended gestational age ≥ 41 weeks (OR 1.9, 95% CI 1.2-3.0) and induction to delivery interval of 48 h or more (OR 2.0, 95% CI 1.2-3.3). The risk of neonatal infection was associated with nulliparity (OR 3.3, 95% CI 1.4-8.0), gestational age ≥ 41 weeks (OR 1.9, 95% CI 1.09-3.36) and induction to delivery interval of 48 h or more (OR 3.4, 95% CI 1.9-6.0). Use of balloon catheter in women with term PROM appears safe and was not associated with increased maternal or neonatal infectious morbidity. This article is protected by copyright. All rights reserved.