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Six versus twelve hours of single-balloon catheter placement with oxytocin administration for labor induction: a randomized controlled trial.
- Source :
- American Journal of Obstetrics & Gynecology; Jun2021, Vol. 224 Issue 6, p611.e1-611.e8, 1p
- Publication Year :
- 2021
-
Abstract
- <bold>Background: </bold>Induction of labor is common in the United States. Multiple previous studies have tried to outline a faster time to delivery to improve maternal and fetal outcomes.<bold>Objective: </bold>This study aimed to evaluate whether women who undergo induction of labor with a single-balloon catheter and oxytocin have a shorter time to delivery with planned removal of the catheter at 6 vs 12 hours.<bold>Study Design: </bold>In this randomized controlled trial, induction of labor was performed using a combination of single-balloon catheter and oxytocin. Term women, both nulliparous and multiparous, aged 18 to 50 years old with cephalic singletons were included if they were undergoing induction of labor with a Bishop score of <6 and cervical dilation of <2 cm. Women were randomized to planned removal of the single-balloon catheter at 6 hours vs 12 hours. The primary outcome was time from catheter insertion to delivery. We were powered to show a 4-hour time difference with a sample size of 89 women per group (n=178). Planned sensitivity analyses were performed to account for cesarean delivery in labor.<bold>Results: </bold>From February 2019 to June 2020, 237 women were screened, 178 women were randomized, and 177 women were included in the final analysis (89 women in the 6-hour group and 88 women in the 12-hour group). Insertion to delivery time was significantly shorter in the 6-hour group (19.2 vs 24.3 hours; P=.04), and the proportion of women delivered by 24 hours was significantly greater in the 6-hour group (67.4% vs 47.4%; P<.01). There was no difference in the Bishop score at removal of the catheter or secondary maternal or neonatal outcomes. In a Cox proportional-hazards model censoring for cesarean delivery, the 6-hour group had a significantly shorter insertion to delivery time (hazard ratio, 0.67; P=.02).<bold>Conclusion: </bold>Induction of labor with a single-balloon catheter and oxytocin with planned removal of the catheter at 6 hours rather than 12 hours results in a shorter time from insertion to delivery without increasing the rate of cesarean delivery. Decreasing the length of time a single-balloon catheter is in place should be considered in clinical protocols. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 00029378
- Volume :
- 224
- Issue :
- 6
- Database :
- Supplemental Index
- Journal :
- American Journal of Obstetrics & Gynecology
- Publication Type :
- Academic Journal
- Accession number :
- 150492629
- Full Text :
- https://doi.org/10.1016/j.ajog.2021.03.021