title: [Double-balloon device and intravaginal dinoprostone for cervical ripening in women with unfavourable cervix].
abstract: OBJECTIVE
  To compare the efficiency of a double cervical ripening (mechanical agent and dinoprostone) to a dinoprostone-only ripening in women with an unfavourable cervix.
  
  
  METHODS
  In a retrospective study from January 2008 to October 2013, 96 patients were included with the following criteria: pregnancies over 37 weeks, singleton, vertex presentation, medical indication for induction of labor, no premature rupture of membranes and very unfavourable cervix (Bishop score ≤ 3). Patients were classified into 2 groups: intravaginal dinoprostone for 24h (prostaglandin group, n=38) and double-balloon device for 12h followed by intravaginal dinoprostone for 24h (balloon+prostaglandin group, n=58).
  
  
  RESULTS
  There was no difference in vaginal delivery rates between the 2 groups (balloon+prostaglandin group 51.7%, prostaglandin group 50%, P=0.87). The Bishop score after cervical ripening was significantly higher in the balloon+prostaglandin group (4.4 versus 2.4, P<0.0001), but the interval between the induction and the delivery was longer (33.6h versus 24.9h, P=0.0044). There was no significant difference for maternal and neonatal complications.
  
  
  CONCLUSIONS
  A double cervical ripening (with mechanical agent and dinoprostone) allows the Bishop score to be improved without increasing the rate of vaginal delivery, for patients with a Bishop score ≤ 3.
authors.affiliation: Service de gynécologie-obstétrique, pavillon Mère-Enfants, hôpital Charles-Nicolle, CHU de Rouen, 1, rue de Germont, 76031 Rouen cedex, France. Electronic address: maria.letailleur@gmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Letailleur
authors.affiliation: Service de gynécologie-obstétrique, pavillon Mère-Enfants, hôpital Charles-Nicolle, CHU de Rouen, 1, rue de Germont, 76031 Rouen cedex, France.
authors.forename: N
authors.initials: N
authors.lastname: Mathieu
authors.affiliation: Service de gynécologie-obstétrique, pavillon Mère-Enfants, hôpital Charles-Nicolle, CHU de Rouen, 1, rue de Germont, 76031 Rouen cedex, France.
authors.forename: G
authors.initials: G
authors.lastname: Dietrich
authors.affiliation: Service de gynécologie-obstétrique, centre hospitalier du Belvédère, 72, rue Louis-Pasteur, BP 45, 76131 Mont-Saint-Aignan cedex, France.
authors.forename: C
authors.initials: C
authors.lastname: Lethuilier
authors.affiliation: Service de gynécologie-obstétrique, pavillon Mère-Enfants, hôpital Charles-Nicolle, CHU de Rouen, 1, rue de Germont, 76031 Rouen cedex, France.
authors.forename: E
authors.initials: E
authors.lastname: Verspyck
authors.affiliation: Service de gynécologie-obstétrique, pavillon Mère-Enfants, hôpital Charles-Nicolle, CHU de Rouen, 1, rue de Germont, 76031 Rouen cedex, France.
authors.forename: L
authors.initials: L
authors.lastname: Marpeau
mesh_terms: D000282:Administration, Intravaginal; D000328:Adult; D057785:Catheters; D020070:Cervical Ripening; D015232:Dinoprostone / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007751:Labor, Induced / Q000295:instrumentation* / Q000379:methods*; D010120:Oxytocics / Q000627:therapeutic use; D011247:Pregnancy; D012189:Retrospective Studies
chemical_list: D010120:Oxytocics; D015232:Dinoprostone
keywords: Cervical ripening; Col défavorable; Dinoprostone; Double ballonnet; Double-balloon catheter; Déclenchement du travail; Labour induction; Maturation cervicale; Unfavourable cervix