Second dose of PGE vaginal insert versus Foley transcervical balloon for induction of labor after failure of cervical ripening with PGE vaginal insert.

PURPOSE

To determine the success rate of induction of labor (IOL) using Foley transcervical balloon (FTB) versus prostaglandin E (PGE) vaginal insert, following failure of cervical ripening with PGE vaginal insert.

MATERIALS AND METHODS

A retrospective cohort study of all pregnant women admitted for IOL with either FTB or PGE vaginal insert. Either second dose of PGE vaginal insert or FTB was used as a second line treatment after failure (not giving birth in 24 h from insertion) of first PGE vaginal insert.

RESULTS

During the study period, 1162 women were admitted for IOL. Failure was reported in 322/852 (37.8%) in the FTB versus 162/310 (52.2%) in the PGE group (p < 0.001). Among 162 patients treated with PGE as first line who did not deliver after 24 h, 14 had spontaneous rupture of membranes, 15 underwent stripping and 42 were in still in active labor. The remainder were allocated to either second trial of PGE treatment (n = 58) or FTB (n = 33) with failure rate higher in the PGE group, not statistically significant (p = 0.23).

CONCLUSION

IOL with FTB was not superior to PGE vaginal insert for IOL following failure of cervical ripening with PGE vaginal insert.