Maturation du col utérin défavorable par ballonnet supra-cervical sur utérus cicatriciel: étude rétrospective multicentrique de 151 patientes [Balloon catheter for cervical ripening on scarred uterus with unfavorable cervix: Multicenter retrospective study of 151 patients]

摘要

Objectives To evaluate safety and efficacy of balloon catheter for labor induction in women with previous cesarean section. Material and methods In a multicenter retrospective cohort study, 151 patients were included with the following criterias: pregnancy over 37 weeks, singleton, vertex presentation, previous caesarean section with unique transversal segmentary incision, medical indication for induction of labor, unfavorable cervix with Bishop score inferior to 7, no premature rupture of membranes. Balloon catheter used for cervix ripening, is inflated from 30 to 80 mL of sterile of NaCl and is left until 24 hours. Results Overall rate of vaginal delivery was 53.7% (81/151). Labor began before balloon catheter removal for 58 out of 151 (38.4%) with vaginal delivery for 75% (42/58). Best prognosis factors for vaginal delivery were spontaneous labor after balloon removal (P = 0.004) and anterior vaginal delivery (P = 0.03). Side effects were rare bleeding or PROM, but didn't prevent continuing ripening labor. Other morbidity consisted in two uterus ruptures (1.2%) without maternofetal incidence. Conclusion Supracervical balloon is a safe and efficiency method for inducing labor on scarred uterus with unfavorable cervix with low side effects.