Intravaginal Prostaglandin E2 Versus, Double Balloon Catheter For Labor Induction In Term Isolated Oligohydramnios

Induction of labor for term patients with oligohydramnios is advocated by experts to reduce perinatal morbidity and mortality. The better mode of cervical ripening for those patients has not been determined. The aim of this study was to compare mechanical and pharmacological ripening methods for term patients with oligohydramnios. 50 patients with a singleton term pregnancy who were diagnosed with amniotic fluid index (AFI ) below 5 cm and an unripe cervix were randomized for induction of labor with double balloon catheter or with slow release vaginal prostaglandin E2 (PGE2; Cervidil®). The primary outcome measure was a 10-hour difference in time from induction to active labor. Labor and delivery course, maternal satisfaction, and early neonatal outcomes were evaluated. There were no demographic differences between groups. Time from induction to delivery was 19.1 hours in the PGE2 group vs. 23.4 hours in the catheter group. The differences in were not statistically significant, although more mothers in the catheter group received oxytocin after ripening (84.6% vs. 54.2%; P=.019), respectively. More fetuses had insignificant fetal heart rate decelerations during ripening while using PGE2 (33.3%) compared to the catheter (0%; P=0.002). Induction was stopped earlier than planned in 75% of the PGE2 group compared to 27% of the catheter group (P=0.001), mostly due to progression to active labor. No differences in delivery methods or early neonatal outcomes were found. Higher maternal satisfaction rates were reported with PGE2. Intravaginal dinoprostone and double balloon catheter are comparable for cervical ripening in oligohydramnios at term pregnancies.Tabled 1Main results