title: Double balloon catheter for induction of labour in Chinese women with previous caesarean section: one-year experience and literature review.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of double balloon catheter for induction of labour in Chinese women with one previous caesarean section and unfavourable cervix at term.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  A regional hospital in Hong Kong.
  
  
  METHODS
  Women with previous caesarean delivery requiring induction of labour at term and with an unfavourable cervix from May 2013 to April 2014.
  
  
  METHODS
  Primary outcome was to assess rate of successful vaginal delivery (spontaneous or instrument-assisted) using double balloon catheter. Secondary outcomes were double balloon catheter induction-to-delivery and removal-to-delivery interval; cervical score improvement; oxytocin augmentation; maternal or fetal complications during cervical ripening, intrapartum and postpartum period; and risk factors associated with unsuccessful induction.
  
  
  RESULTS
  All 24 Chinese women tolerated double balloon catheter well. After double balloon catheter expulsion or removal, the cervix successfully ripened in 18 (75%) cases. The improvement in Bishop score 3 (interquartile range, 2-4) was statistically significant (P<0.001). Overall, 18 (75%) cases were delivered vaginally. The median insertion-to-delivery and removal-to-delivery intervals were 19 (interquartile range, 13.4-23.0) hours and 6.9 (interquartile range, 4.1-10.8) hours, respectively. Compared with cases without, the interval to delivery was statistically significantly shorter in those with spontaneous balloon expulsion or spontaneous membrane rupture during ripening (7.8 vs 3.0 hours; P=0.025). There were no major maternal or neonatal complications. The only factor significantly associated with failed vaginal birth after caesarean was previous caesarean section for failure to progress (P<0.001).
  
  
  CONCLUSIONS
  This is the first study using double balloon catheter for induction of labour in Asian Chinese women with previous caesarean section. Using double balloon catheter, we achieved a vaginal birth after caesarean rate of 75% without major complications.
authors.affiliation: Department of Obstetrics and Gynaecology, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong.
authors.forename: Queenie K Y
authors.initials: QK
authors.lastname: Cheuk
authors.affiliation: Department of Obstetrics and Gynaecology, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong.
authors.forename: T K
authors.initials: TK
authors.lastname: Lo
authors.affiliation: Department of Obstetrics and Gynaecology, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong.
authors.forename: C P
authors.initials: CP
authors.lastname: Lee
authors.affiliation: Department of Obstetrics and Gynaecology, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong.
authors.forename: Anita P C
authors.initials: AP
authors.lastname: Yeung
mesh_terms: D000328:Adult; D057785:Catheters / Q000009:adverse effects; D020070:Cervical Ripening; D002585:Cesarean Section; D002681:China; D004420:Dystocia / Q000601:surgery; D005260:Female; D006801:Humans; D007751:Labor, Induced / Q000295:instrumentation*; D010120:Oxytocics; D010121:Oxytocin; D036801:Parturition; D011247:Pregnancy; D012189:Retrospective Studies; D013997:Time Factors; D016064:Vaginal Birth after Cesarean / Q000295:instrumentation*
chemical_list: D010120:Oxytocics; D010121:Oxytocin
keywords: Catheters; Cesarean section; Labor, induced