Intracervical balloon catheter compared to oxytocin for cervical ripening in scarred uterus

The rising cesarean section rate in France highlights a critical need for safe and effective labor induction methods, particularly for women with a scarred uterus due to previous C-sections. Current guidelines often restrict the use of prostaglandins in these patients due to the increased risk of uterine rupture. While intracervical balloon catheters are a known alternative for cervical ripening in nulliparous women, their efficacy and safety in women with a scarred uterus and an unfavorable cervix (Bishop score <4) remain underexplored, presenting a significant clinical gap.

Investigators propose a prospective randomized trial comparing two methods for cervical ripening in women with a scarred uterus and an unfavorable cervix (Bishop score <4). The intervention arm will receive an intracervical balloon catheter, inflated with 50 ml sterile water and left in place for 12 hours. The control arm will receive oxytocin, which is considered the reference method. The primary endpoints are to assess the safety of the balloon method and its effectiveness in increasing vaginal delivery rates for this specific patient population.

This abstract describes a proposed prospective randomized trial, and therefore, no actual findings are presented from the study itself. The investigators expect to demonstrate that the intracervical balloon method is a safe and effective alternative to oxytocin for inducing labor in women with a scarred uterus and an unfavorable cervix (Bishop score <4). Specifically, they anticipate that the balloon catheter will lead to an increased rate of vaginal delivery while maintaining safety for this high-risk population, potentially reducing the need for repeat cesarean sections. The study aims to provide robust evidence for a non-prostaglandin option in this specific clinical scenario, addressing a significant gap in current practice guidelines.