Maternal or fetal complications, following the insertion of a balloon catheter to induce labour, are rare. Pain or discomfort was most common affecting around 1 in 400 women. Balloon displacement, bleeding or abnormal fetal heart rate affected less than 1 in 1,000.
The catheter is a device inserted through the cervix, where inflated balloons on the end of a tube put pressure on the cervix helping it to “ripen” and start contractions. Prostaglandin drugs are the current recommended induction method, but uterine (womb) overstimulation, where contractions become too frequent or long, is a recognised side effect.
Individual trials have indicated that catheter induction could be a safer alternative. This review is the first to gather the available evidence from 26 studies including 8,292 women that have reported the adverse event rate for catheters.
It supports balloon catheters as an induction method for low-risk pregnancies that could allow women to stay at home, benefiting the mother and saving NHS resources.
“This review provides encouraging evidence for the safety of balloon catheter cervical ripening in an outpatient setting. Adopting this technique for low-risk pregnancies could significantly improve women’s birth experience as well as economically benefiting the NHS. Is it time we reconsidered our induction methods?”
Sally Collins, Consultant Obstetrician & Subspecialist in Maternal & Fetal Medicine, Oxford University Hospitals NHS Foundation Trust; Associate Professor, Nuffield Department of Women’s & Reproductive Health, University of Oxford; Lecturer in Medical Sciences, St Anne’s College, University of Oxford
Diederen M, Gommers J, Wilkinson C, et al. Safety of the balloon catheter for cervical ripening in outpatient care: complications during the period from insertion to expulsion of a balloon catheter in the process of labour induction: a systematic review. BJOG. 2017. [Epub ahead of print].
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