Effectiveness and safety of dinoprostona and cook’s balloon for labour induction in pregnants with small for gestational age fetuses

Abstract

Objectives: To compare the effectiveness (hours until delivery) and safety (rate of vaginal deliveries and caesarean sections, use of oxytocin and perinatal outcomes) of dinoprostone and Cook's balloon as a method of labor induction in pregnant women with fetuses with an estimated weight below the 10th percentile and normal Doppler. Methods: retrospective cohort review of pregnant women with small for gestational age fetuses and induced with both methods in Reina Sofía Hospital, Cordoba, Spain from 2014 to 2018. The main outcome was time until delivery. Descriptive characteristics, obstetric and perinatal outcomes were analyzed. 322 pregnant women were induced: 204 women were induced with Cook's balloon (CB) and 118 with dinoprostone (DIN). RESULTS: Dinoprostone decreases the time until delivery (28.86 vs. 24.32 hours with CB and DIN, respectively, p<0.0001) and the use of oxytocin (79.7% vs 54.2% in CB and DIN group; p<0,01), as compared to Cook's balloon. No differences were observed in the rate of caesarean sections and vaginal deliveries, as well as in perinatal results. Conclusion: DIN reduces the time to delivery compared to CB with a lower need for oxytocin. Moreover, without worse perinatal outcomes.