Case series of labor induction in twin gestations with an intrauterine balloon catheter

The efficacy and safety of labor induction using an intrauterine balloon ca theter in twin pregnancies has been evaluated. During the study period (199 2-1997), labor was induced at 36-42 weeks in 17 twin gestations. Labor indu ction was indicated for preeclampsia (n = 10), birth weight discordance (n = 3), suspected fetal distress (n = 2) and postdates (n = 2). Twin A was in vertex presentation in all cases. An intrauterine balloon catheter was ins erted transcervically followed by augmentation whenever required. Vaginal d elivery was achieved in 15 (88.2%) patients. The mean interval from balloon insertion to delivery was 17.05 h, with 80% deliveries occurring within 24 h of catheter insertion and 80% occurring within 12 h of catheter expulsio n. Birth weight was 2,514 +/- 244 and 2,421 +/- 367 g for twin A and B, res pectively. Oxytocin was required in 4 patients. Postpartum hemorrhage was n oted in 1 patient. One patient with no progress of labor and 1 with suspect ed intrapartum fetal distress required cesarean section. All neonates had a 5-min Apgar score of 10. The data suggest that an intrauterine balloon cat heter appears to be safe and effective to induce labor in twin gestations.