2,702 results match your criteria: "Cervical Ripening"
Cervical ripening at home or in hospital during induction of labour: the CHOICE prospective cohort study, process evaluation and economic analysis.
Health Technol Assess
December 2024
Usher Institute, University of Edinburgh, Edinburgh, UK.
Background: Around one in three pregnant women undergoes induction of labour in the United Kingdom, usually preceded by in-hospital cervical ripening to soften and open the cervix.
Objectives: This study set out to determine whether cervical ripening at home is within an acceptable safety margin of cervical ripening in hospital, is effective, acceptable and cost-effective from both National Health Service and service user perspectives.
Design: The CHOICE study comprised a prospective multicentre observational cohort study using routinely collected data (CHOICE cohort), a process evaluation comprising a survey and nested case studies (qCHOICE) and a cost-effectiveness analysis.
Assessing the timing of amniotomy after Foley balloon catheter removal in women with labor induction: The role of Bishop score: An observational study.
Medicine (Baltimore)
December 2024
Department of Obstetrics and Gynecology, Taixing People's Hospital, Taixing, China.
The timing of amniotomy after the Foley balloon catheter removal is crucial for successful labor induction. This study aimed to assess the effects of the Bishop score on the timing of amniotomy in patients undergoing labor induction after the Foley balloon catheter removal. This was a retrospective cohort study based on electronic medical records.
View Article and Find Full Text PDFComparison of balloon catheter and oral misoprostol for cervical ripening in women with pre-labor rupture of membranes: A Finnish randomized controlled trial.
Acta Obstet Gynecol Scand
December 2024
Department of Obstetrics and Gynecology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Introduction: Pre-labor rupture of membranes (PROM) occurs in about 8% of term pregnancies with over 70% delivering spontaneously within 24 h. However, prolonged PROM increases the risk of chorioamnionitis and neonatal sepsis. While misoprostol and oxytocin are considered safe and effective methods of labor induction, most guidelines do not encourage balloon catheter (BC) use following PROM given concerns about increased risk of chorioamnionitis.
View Article and Find Full Text PDFTugging the Foley Catheter Balloon Every Three Hours in Induction of Labor After One Previous Cesarean: A Randomized Controlled Trial.
Am J Obstet Gynecol MFM
December 2024
Department of Obstetrics and Gynecology, Faculty of Medicine, Universiti Malaya, Jalan Profesor Diraja Ungku Aziz, 50603, Kuala Lumpur, Malaysia. Electronic address:
Article Synopsis
- Induction of labor after a previous cesarean poses high risks, and using a Foley balloon for mechanical ripening is preferred over prostaglandins due to lower risk of complications like uterine rupture.
- This study aims to assess the effects of tugging the Foley balloon every three hours on the time from induction to delivery and overall patient satisfaction compared to standard care without tugging.
- Conducted as a randomized controlled trial in Malaysia from April 2023 to March 2024, 126 participants were recruited, and outcomes measured included the time interval from balloon insertion to delivery and participants' satisfaction, with expectations of a significant reduction in delivery time and improvement in satisfaction scores.
Dilapan-S versus Standard Methods for Cervical Ripening in Term Pregnancies: An Individual Patient Data Meta-Analysis.
Am J Obstet Gynecol MFM
December 2024
Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, Eastern Virginia Medical School, Norfolk, VA.
Objectives: Dilapan-S is a cervical ripening agent approved by the FDA that has been found to be just as effective as other agents and can be utilized for outpatient ripening. No large-scale studies have been conducted to compare cesarean delivery rates between Dilapan-S and other ripening methods. Our objective was to combine these trials to compare cesarean delivery rates for Dilapan-S with other cervical ripening methods, overall and in sub-groups.
View Article and Find Full Text PDFComparison of balloon catheter, oral misoprostol, or combination of both for cervical ripening in late-term and post-term nulliparous women: A Finnish randomized controlled multicenter pilot trial.
Acta Obstet Gynecol Scand
December 2024
Department of Obstetrics and Gynecology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Introduction: Nulliparous women beyond term have high rates of induction failure. The aim of this study was to compare delivery outcomes for balloon catheter, misoprostol, and combination of both in nulliparous late- and post-term women with unfavorable cervices. We intended to explore whether the combination strategy has lower cesarean section rate and is as safe as either method alone.
View Article and Find Full Text PDFSupporting Labor After 2 Cesarean Births.
J Midwifery Womens Health
December 2024
Fairfield University Marion Peckham Egan School of Nursing and Health Studies, Fairfield, Connecticut.
Labor after cesarean (LAC) is a safe alternative for pregnant persons who have had 1 or 2 previous cesarean births (CBs) and have no contraindication to vaginal birth. When compared with repeat CB, vaginal birth after cesarean (VBAC) reduces short- and long-term health complications and morbidity and should therefore be presented as an option. Despite recommendations from the American College of Nurse-Midwives and the American College of Obstetricians and Gynecologists in support of LAC, not all pregnant persons who are candidates have access to this option.
View Article and Find Full Text PDFLogistics for achieving delivery: A secondary analysis of the home induction randomised controlled trial.
Eur J Obstet Gynecol Reprod Biol
December 2024
Rotunda Hospital, Dublin, Ireland; Department of Obstetrics and Gynaecology, Royal College of Surgeons in Ireland, (RCSI), University of Medicine and Health Sciences, Dublin, Ireland.
Objective: This secondary analysis evaluates the logistics of achieving vaginal delivery following outpatient induction. This includes changes in Bishop score before and after cervical ripening, the need for additional ripening agents, time interval from induction to delivery, all of which provide invaluable information when developing an outpatient induction of labour service.
Study Design: We randomised healthy nulliparous women with no significant medical history, who agreed to elective induction of labour at 39 weeks' gestation, to one of three forms of initial cervical ripening at home: 12 h of Dilapan-S, 24 h of Dilapan-S, or 24 h of slow-release dinoprostone (Propess).
Diagnostic accuracy of strain cervical elastography as a predictor for preterm delivery: A single tertiary care centre study.
Ultrasound
November 2024
Department of Radiodiagnosis, IGMC, Shimla, India.
Article Synopsis
- Preterm delivery significantly contributes to neonatal deaths and long-term health issues, presenting a major global health challenge, with cervical elastography emerging as a promising diagnostic tool for predicting such deliveries.
- The study assessed the effectiveness of transvaginal strain cervical elastography in predicting preterm delivery among 75 low-risk, asymptomatic women, utilizing ultrasound to analyze cervical length and strain data.
- Findings revealed that a red color sign at the anterior lip of the cervix was a strong predictor of preterm delivery, alongside additional indicators like an elastography strain ratio greater than 2 and a cervical length of 2.8 cm or less.
[Guideline of cervical ripening and labor induction during the third trimester pregnancy (2024)].
Zhonghua Fu Chan Ke Za Zhi
November 2024
Transvaginal ultrasonography-measured cervical length versus the modified Bishop score for preinduction cervical assessment at term: A randomised controlled trial.
Ultrasound
November 2024
Division of Maternal and Fetal Medicine, Department of Gynaecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Article Synopsis
- The study aimed to compare the effectiveness of transvaginal ultrasound measurements of cervical length and the modified Bishop score in assessing cervical readiness for labor induction in pregnant women.
- Involving 72 nulliparous women, participants were randomly assigned to either the ultrasound or Bishop score group to evaluate cervical 'ripeness' based on specific criteria.
- The results showed no significant differences in the mode of delivery, amount of prostaglandins used, or labor intervals between the two groups, indicating both methods are similarly effective for preinduction assessment.
Prevalence of failed induction of labor and associated factors among women who underwent induction of labor in Ethiopia: A systematic review and meta-analysis.
PLoS One
November 2024
Department of Midwifery, College of Medicine and Health Science, Woldia University, Woldia, Ethiopia.
Article Synopsis
- Failed induction of labor in Ethiopia is linked to increased health risks for mothers, including complications from cesarean deliveries and higher mortality rates.
- A systematic review and meta-analysis were conducted on studies from 2013 to 2023, including 28 studies with 9,757 participants, to assess the prevalence and associated factors of failed induction.
- The findings revealed a pooled prevalence of 22.39%, with higher rates in Addis Ababa, and identified risk factors such as rural residency, being a first-time mother, an unfavorable Bishop score, hypertension, and premature rupture of membranes.
Cost-Effectiveness Analysis of a Randomized Clinical Trial of Outpatient vs Inpatient Cervical Ripening Using Synthetic Osmotic Dilators.
Am J Obstet Gynecol MFM
November 2024
Department of Obstetrics and Gynecology, The University of Texas Medical Branch at Galveston, Galveston, TX.
Comparison of the efficacy and safety of dinoprostone and double-balloon catheters in cervical ripening: a propensity score matching retrospective study.
Ginekol Pol
November 2024
Department of Obstetrics and Gynecology, The Affiliated Changzhou Second People's Hospital of Nanjing Medical University, Changzhou, Jiangsu, P.R. China.
Article Synopsis
- This study examines the effectiveness and safety of dinoprostone versus double-balloon catheters (DBC) for cervical ripening in primipara women during labor induction.
- A total of 877 women were split into two groups based on the method used, with the study comparing natural birth rates, time to labor, and complications for both groups.
- Results indicated that dinoprostone led to a better Bishop score and lower rates of puerperal infection compared to DBC, but without a significant difference in overall vaginal delivery success rates.
Vaginal microbiota in term pregnant women with differences in cervical ripeness revealed by 2bRAD-M.
BMC Microbiol
November 2024
Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui Province, China.
Article Synopsis
- - The study investigates how vaginal microbiota may influence cervical ripening in term primiparous women, using a new sequencing technology called microbiome 2bRAD sequencing to analyze the vaginal microbiota of participants with varying cervical ripeness scores.
- - Thirty full-term primigravid women were involved, divided into low and high cervical ripeness scoring groups; analyses revealed 605 species without significant diversity differences but identified specific key species associated with each group.
- - Findings highlighted that species like Lactobacillus crispatus and Lactobacillus iners were crucial, and certain other species showed distinct abundances between the groups, suggesting a potential microbiota impact on cervical ripening outcomes.
Factors associated with insufficient cervical ripening in a controlled-release dinoprostone vaginal delivery system: A single perinatal center retrospective study.
Taiwan J Obstet Gynecol
November 2024
Department of Obstetrics and Gynecology, Nippon Medical School Musashikosugi Hospital, 1-383 Kosugi-cho, Nakahara-ku, Kawasaki, Kanagawa, Japan.
Article Synopsis
- - This study looked at factors influencing inadequate cervical ripening in pregnant women using a controlled-release dinoprostone vaginal delivery system (Propess) for labor induction.
- - Out of 103 women, 49 experienced insufficient cervical ripening, with maternal age ≥35 years and early-term delivery found to be significant predictors of this issue.
- - The findings suggest that adjusting induction protocols based on individual maternal characteristics could improve the effectiveness of Propess in managing labor.
Vaginal delivery following induction and associated factors among laboring women at South Wollo Zone Public Hospitals of Ethiopia, 2023.
Sci Rep
October 2024
Department of Midwifery, College of Medicine and Health Science, Debre Markos University, Debre Markos, Ethiopia.
Article Synopsis
- A study conducted in South Wollo Zone, Ethiopia, in 2023, aimed to determine the rate and factors associated with successful vaginal delivery after labor induction.
- Out of 385 participants, the study found that 75.6% experienced vaginal delivery, with several key factors influencing success, including mid-upper arm circumference, multiparity, bishop score, use of oxytocin with cervical ripening, and baby weight.
- The findings suggest that healthcare providers should focus on evaluating these factors before induction to improve delivery outcomes and enhance maternal and perinatal health.
How labor induction methods have evolved throughout history, from the Egyptian era to the present day: evolution, effectiveness, and safety.
Am J Obstet Gynecol MFM
October 2024
Department of Obstetrics & Gynecology, Monash University, Monash Medical Centre, Clayton, Victoria, Australia (Patabendige, Rolnik, Li, and Mol); Women's and Newborn, Monash Health, Victoria, Australia (Patabendige, Rolnik, and Mol).
Article Synopsis
- * Early interventions included natural remedies like castor oil in Egypt and mechanical methods from Hippocratic practices around 2500 years ago, transitioning to pharmacological options in the mid-20th century.
- * Today's IOL methods focus on key factors like effectiveness, safety, cost, and client satisfaction, with ongoing research and evidence from randomized controlled trials shaping future practices.
A double-blind, randomized, placebo-controlled trial of melatonin as an adjuvant agent for induction of labor: The MILO trial.
Acta Obstet Gynecol Scand
December 2024
The Ritchie Centre, Hudson Institute of Medical Research, Clayton, Victoria, Australia.
Article Synopsis
- This study investigates the effect of melatonin on reducing cesarean births during labor induction, hypothesizing that it may help lower the need for surgical intervention.
- The trial was randomized and double-blind, involving 189 women with healthy singleton pregnancies, comparing those given 10 mg of melatonin to a placebo.
- Results showed that cesarean rates were similar between the two groups, but the melatonin group had a lower rate of spontaneous vaginal births within 24 hours, leading to early termination of the trial due to logistical issues from the COVID-19 pandemic.
Cervical ripening with a double balloon device for 6 h in patients with a long cervix: Secondary analysis of a randomized controlled trial.
Int J Gynaecol Obstet
October 2024
Department of Obstetrics and Gynecology, Bnai-Zion Medical Center, Technion - Israel Institute of Technology, Haifa, Israel.
Article Synopsis
- - The study aimed to assess the effectiveness of using a double balloon device for cervical ripening for 6 hours compared to 12 hours in patients with a cervical length of 30 mm or more before labor induction.
- - It was a secondary analysis involving 67 women, where the main focus was the change in Bishop score after removing the device, with secondary measures like delivery timing and oxytocin use.
- - Results showed no significant difference in Bishop score changes between the two time groups, but the 6-hour group had a notably shorter delivery time by 10 hours compared to the 12-hour group.
Efficacy of controlled-release dinoprostone vaginal insert for elective induction of labor before due date.
J Obstet Gynaecol Res
December 2024
Department of Obstetrics and Gynecology, Keio University School of Medicine, Shinjuku, Tokyo, Japan.
Article Synopsis
- The study aims to compare the effectiveness of controlled-release dinoprostone (PGE) vaginal inserts against mechanical dilation methods for inducing labor before the due date, as research shows PGE may reduce cesarean sections without increasing risks to newborns.
- The retrospective analysis involved 206 mothers at 37 to 39 weeks of gestation, evaluating perinatal outcomes and the success rates of vaginal deliveries within 48 hours of starting oxytocin augmentation.
- Results showed a higher success rate of vaginal delivery in the PGE group (80.4%) compared to the non-PGE group (66.2%), with no emergency cesarean sections in the PGE group, suggesting that PGE may be a beneficial option for elective labor
Evaluation of an Outpatient Cervical Ripening Program Using Osmotic Dilators and Foley Balloon Catheters.
Am J Perinatol
October 2024
Allina Health, Minneapolis, Minnesota.
Article Synopsis
- * A total of 120 patients were included; findings showed similar cervical changes between the two device types, with most patients (74.8%) achieving vaginal delivery and expressing high satisfaction, especially those using osmotic dilators.
- * The study concludes that outpatient cervical ripening is generally safe and satisfying, with low stress levels and a common recommendation for the procedure among patients.
Efficacy of Dilapan S compared to foley balloon in preinduction cervical ripening-a noninferiority trial.
AJOG Glob Rep
November 2024
Department of Obstetrics and Gynaecology, PSGIMSR, Coimbatore, Tamil Nadu, India (Maheshwari).
Article Synopsis
Digital versus speculum-based balloon catheter insertion for labor induction: a systematic review and meta-analysis.
Am J Obstet Gynecol MFM
December 2024
Department of Obstetrics and Gynaecology, Monash University, Faculty of Medicine, Nursing and Health Sciences, Monash Medical Centre, 246 Clayton Rd, Clayton, Victoria 3168 Australia (Seo, Davies-Tuck, Warty, Smith, and Palmer); Monash Women's, Monash Health, 246 Clayton Rd, Clayton, Victoria Australia (Palmer).
Article Synopsis
- The study examines the effectiveness, safety, and acceptability of two methods for cervical preparation prior to labor induction: digital insertion vs. speculum-based insertion of catheter balloons.
- It utilized various medical databases to find randomized controlled trials that met specific criteria, focusing on viable singleton pregnancies and excluding studies that didn't involve cervical balloons.
- The results indicated that while digital insertion was generally less painful and had comparable maternal satisfaction, overall outcomes showed no significant difference between the two methods, despite some concerns over study biases.