INDUCTION OF LABOR BY BALLOON CATHETER WITH EXTRAAMNIOTIC SALINE INFUSION (BCEAS) - A RANDOMIZED COMPARISON WITH PGE2 VAGINAL PESSARIES

Objective: A new method for induction of labour - balloon catheter wit h extra-amniotic saline infusion (BCEAS) - is evaluated in randomised comparison with prostaglandin E2 (PGE2) in vaginal pessaries. Study gr oup: One-hundred and nine pregnant women with unfavourable cervices. M ajor outcome measures: The efficiency of inducing vaginal delivery and the level of 'disadvantages following induction of labour' (DisFIL sc orings). Results: Overall, BCEAS was less efficient inducing vaginal d elivery than vaginal PGE2 (P < 0.01) because of a significant differen ce among parous women (P < 0.01). In the (larger) primiparous women gr oup, and particularly in the subgroup of these having very low pelvic scores (Lange score, less-than-or-equal-to 3), the efficiencies of the two methods were equal (P = 0.06) and P = 0.55, respectively). The le vels of DisFIL scorings were not significantly different. However, hig her rates of caesarean section followed BCEAS than PGE2 (29% and 10%, respectively; P < 0.05). Serious infectious complications were not rec orded following BCEAS. No difference was apparent in the status of the neonates (judging from Apgar scores and umbilical artery pH and SBE). The women, delivering vaginally, commented the two methods equally fa vourably. Conclusion: BCEAS was less efficacious than vaginal PGE2 pes saries, though among primiparous women, especially those with very unf avourable cervices, the difference was not significant. Further refine ments of the method are suggested.