title: [Expansion dilatation balloons for cervical ripening in obstetric practice].
abstract: During recent decades, mechanical devices have been substituted by pharmacological methods. Their place in the therapeutic arsenal remains important with a renewed obstetrical interest for these devices. Due to a lack of data they are still not recommended as first-line. This review thus attempted to examine the use of expansion dilatation balloons (Foley catheter and double-balloons) to analyze their effectiveness in case of native uterus and previous cesarean section. Twenty-seven clinical trials had compared balloons catheter and prostaglandins in patients without a history of uterine scar. The risk of cesarean section did not differ. Mechanical methods seemed to be more effective in achieving delivery within 24hours, with fewer episodes of excessive uterine contractions, but they necessitated more oxytocin during labor. Ten clinical trials analyzed dilatation balloons in patients with previous cesarean section. More than 70% women had favorable cervical ripening (Bishop score>6), and vaginal delivery was reported between 35 and 70% of patients. The risk of uterine rupture was low between 0.64 and 0.72%, with neither increased risk of severe neonatal and maternal morbidity nor increased risk of infectious morbidity. Mechanical methods are effective and safe for third trimester cervical ripening, mainly in women with previous cesarean section. Potential advantages may include wide availability and reduction of some of the side effects.
authors.affiliation: Service de gynécologie-obstétrique, centre hospitalier départemental, Les Oudairies, 85000 La Roche-sur-Yon, France. Electronic address: g.ducarme@gmail.com.
authors.forename: G
authors.initials: G
authors.lastname: Ducarme
authors.affiliation: Service de gynécologie-obstétrique, centre hospitalier départemental, Les Oudairies, 85000 La Roche-sur-Yon, France.
authors.forename: J
authors.initials: J
authors.lastname: Grange
authors.affiliation: Service de gynécologie-obstétrique, centre hospitalier départemental, Les Oudairies, 85000 La Roche-sur-Yon, France.
authors.forename: M
authors.initials: M
authors.lastname: Vital
mesh_terms: D002404:Catheterization / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D020070:Cervical Ripening / Q000502:physiology*; D000075202:Contraindications; D036861:Delivery, Obstetric / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D004106:Dilatation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D007747:Labor Stage, First / Q000502:physiology; D007751:Labor, Induced / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D011247:Pregnancy; D014597:Uterine Rupture / Q000209:etiology / Q000517:prevention & control; D016064:Vaginal Birth after Cesarean / Q000295:instrumentation / Q000379:methods
keywords: Cervical ripening; Cesarean section; Césarienne; Double ballonnet de dilatation; Double-balloon catheter; Déclenchement du travail; Foley catheter; Induction of labor; Maturation cervicale; Sonde de Foley