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The use of cooks balloon for induction of labour: our experience
  1. A Nnochiri,
  2. S Mahavarkar,
  3. C Otigbah
  1. Queen's Hospital, Romford, UK

Abstract

Objective To evaluate the efficacy and outcomes of using the Cook's balloon in induction of labour.

Design Cook's balloon was used as the method for cervical ripening in 43 women from July 2008 to January 2009. The indications for its use were varied, but mostly for failure of induction with prostaglandins, and in those women who opted for vaginal birth after Caesarean section. Women with contraindications to vaginal delivery or ruptured amniotic membranes were excluded.

Outcome Change in bishop score and vaginal delivery.

Method Data were collected prospectively. Women who satisfied the inclusion criteria were assessed and their bishop scores recorded prior to insertion of Cook's Balloon under aseptic conditions. The bishop score was also recorded at the time of removal of the balloon and an amniotomy performed if the cervix was favourable. Syntocinon was used as required.

Results In 24 (56%) women, the indication was failed induction with prostaglandins, while Cook's balloon was the primary method for induction of labour in 19 (44%) women. Vaginal delivery was achieved in 15 (62.5%) women and 12 (63%) women, respectively. The mean change in bishop score was 4.1.

Conclusion Though prostaglandins are still the preferred method for induction of labour in the UK; the authors believe that Cook's balloon can help avoid a certain Caesarean section when they fail. It also provides an effective alternative where the risk of failure with prostaglandins is high (early inductions for obstetric cholestasis, diabetes and intrauterine growth restriction) and where they may be contraindicated (previous Caesarean section).

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