Intra-vaginal prostaglandin E2 versus double-balloon catheter for labor induction in term oligohydramnios

Objective:compare mechanical and pharmacological ripening for patients with oligohydramnios at term.study design:fifty-two patients with oligohydramnios ⩽5 cm and bishop score ⩽6 were randomized for labor induction with a vaginal insert containing 10 mg timed-release dinoprostone (pge2) or double-balloon catheter. the primary outcome was time from induction to active labor. time to labor, neonatal outcomes and maternal satisfaction were also compared.result:baseline characteristics were similar. time from induction to active labor (13 with pge2 vs 19.5 h with double-balloon catheter; p=0.243) was comparable, with no differences in cesarean rates (15.4 vs 7.7%; p=0.668) or neonatal outcomes. the pge2 group had higher incidence of early device removal (76.9 vs 26.9%; p=0.0001), mostly because of active labor or non-reassuring fetal heart rate. fewer pge2 patients required oxytocin augmentation for labor induction (53.8 vs 84.6% p=0.034). time to delivery was significantly shorter with pge2 (16 vs 20.5 h; p=0. 045)conclusion:intravaginal pge2 and double-balloon catheter are comparable methods for cervical ripening in term pregnancies with oligohydramnios.