Transcervical Balloon Catheter for Cervical Ripening: Weighted Traction or Tension [23D]

INTRODUCTION: The goal of induction or augmentation of labor is to achieve vaginal delivery, while balancing both maternal and fetal safety. The rate of induction of labor has more than doubled since 1990, with more than 22% of all gravid women undergoing induction of labor. Several randomized controlled trials have investigated labor outcomes when comparing transcervical balloon catheters to use of prostaglandins or oxytocin. Few studies have investigated methods of transcervical bulb set up. At our institution, mechanical cervical dilation is accomplished with the use of transcervical balloon catheters, which are inflated with 60mL of saline. It is up to provider discretion to place the balloon catheters on traction or tension. METHODS: The objective of this study is to compare pre- and post- transcervical balloon catheter cervical dilations and time from placement to expulsion. Patients were randomized to either the leg or bag group and Bishop score was required to be less than 6. We hypothesized that the use of transcervical balloon catheter on weighted traction would result in a larger cervical dilation and a shorter balloon catheter placement to expulsion time. RESULTS: A total of 73 patients were randomized, with 43 in the bag group and 30 patients in the leg group. Results showed that the intervention of the bag saved 74 minutes of time and was statistically significant, with a p value <.05. Bishop score change between the two groups was not statistically significant, with a p value = .74. At our hospital average cost for labor and delivery is $326 per hour. Average cost savings per patient using bag over leg is $400.98. CONCLUSION: In conclusion, out study demonstrated statistically significant shorter time to delivery in the bag group. This resulted in a shorter induction process, as well as a cost saving to the labor and delivery unit and will be utilized to add evidence to the most efficient method of cervical ripening. Additional research points will analyze time to active phase of labor and time to delivery of the infant