Duration of double balloon catheter for patients with prior cesarean: a before and after study

dc.contributor.authorTang, Rachel J.
dc.contributor.authorBode, Leah M.
dc.contributor.authorBaugh, Kyle M.
dc.contributor.authorMosesso, Kelly M.
dc.contributor.authorDaggy, Joanne K.
dc.contributor.authorGuise, David M.
dc.contributor.authorTeal, Evgenia
dc.contributor.authorChristman, Megan A.
dc.contributor.authorTuskan, Britney N.
dc.contributor.authorHaas, David M.
dc.contributor.departmentObstetrics and Gynecology, School of Medicine
dc.date.accessioned2024-10-16T18:14:52Z
dc.date.available2024-10-16T18:14:52Z
dc.date.issued2024-07-09
dc.description.abstractBackground: Previous studies that suggest a shorter time from cervical ripening balloon placement to delivery with shorter total balloon placement time have excluded patients with prior cesarean deliveries. Objective: To evaluate, in patients with a prior history of cesarean delivery undergoing cervical ripening with a double-balloon catheter, whether planned removal of device after 6 vs 12 hours would result in shorter time to vaginal delivery. Study design: A before-and-after study was performed after a practice change occurred November 2020, shortening the planned time of double-balloon catheter placement for cervical ripening from 12 to 6 hours. Data were collected via retrospective electronic chart review. Primary outcome was time from balloon placement to vaginal delivery. Secondary outcomes included rates of cesarean delivery, maternal intraamniotic infection, and uterine rupture. Kaplan-Meier curves compared median times to delivery between the groups. A Cox proportional-hazards model was used to adjust for time of balloon placement, number of previous vaginal deliveries, and co-medications used. Results: From November 2018 to November 2022, 189 analyzable patients with a prior history of cesarean delivery received a double-balloon catheter for cervical ripening during their trial of labor. Patients were separated into pre- and postpolicy change groups (n=91 and 98, respectively). The median time to vaginal delivery for the pregroup was 28 hours (95% CI: 26, 35) and 25 hours (95% CI: 23, 29) for those in the postgroup (P value .052). After adjusting for dilation at time of balloon placement, number of previous vaginal deliveries, and co-medication, the estimated hazard ratio for successful vaginal delivery postpolicy change was 1.89 (95% CI: 1.27, 2.81). There were no differences in rates of secondary outcomes. Conclusion: In patients with prior cesarean delivery undergoing mechanical cervical ripening with a double-balloon catheter, planned removal at 6 hours compared to 12 hours may result in higher chances of successful vaginal delivery and possibly a shorter time to delivery, without increasing rates of cesarean delivery and intraamniotic infection.
dc.eprint.versionFinal published version
dc.identifier.citationTang RJ, Bode LM, Baugh KM, et al. Duration of double balloon catheter for patients with prior cesarean: a before and after study. AJOG Glob Rep. 2024;4(3):100378. Published 2024 Jul 9. doi:10.1016/j.xagr.2024.100378
dc.identifier.urihttps://hdl.handle.net/1805/44017
dc.language.isoen_US
dc.publisherElsevier
dc.relation.isversionof10.1016/j.xagr.2024.100378
dc.relation.journalAJOG Global Reports
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 Internationalen
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0
dc.sourcePMC
dc.subjectCervical ripening
dc.subjectCervical ripening balloon
dc.subjectCesarean delivery
dc.subjectDouble-balloon catheter
dc.subjectDuration
dc.subjectTrial of labor after cesarean (TOLAC)
dc.subjectVaginal birth after cesarean (VBAC)
dc.titleDuration of double balloon catheter for patients with prior cesarean: a before and after study
dc.typeArticle
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