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CME Credit Offered
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Poster Session 1

(316) Balloon induction in women with previous cesarean delivery: Maternal and neonatal outcomes

Thursday, January 30, 2025
10:30 AM – 12:30 PM  
Objective: Patients planning a trial of labor after a previous cesarean (TOLAC) occasionally need to deliver before onset of  labor due to maternal or fetal conditions and may require induction. There are concerns that  induction might reduce  chances of  vaginal delivery and may increase the risk of uterine rupture.The ideal method for induction in this population have not been well-established and  evidence is inconclusive. Balloon induction gained popularity  due to minimal side effects. However, the adverse effects of balloon induction in women with previous CD remains unclear. We aim to study the influence of balloon induction on  maternal and neonatal adverse effects in women with previous CD

Study Design:

A population-based retrospective cohort study was conducted, including all term (>37 weeks of gestation) singleton pregnancies that underwent balloon induction between February 2020 and January 2022, who had one previous CD at a tertiary medical center. Women who underwent non-mechanical induction, as well as those with no trial of labor, were excluded. Maternal, neonatal and obstetrical complications were compared based on balloon induction of labor exposure. Logistic regression models were used to adjust for confounders.

Results: The study population included 2352 deliveries. Of these, 285 (12.1%) underwent balloon induction of labor, while 2067 (87.9%) did not. Maternal and neonatal complications in both groups are shown in Table 1. The rate of vacuum delivery was significantly higher in the induction group (7.0% vs. 4.1%, p=0.022). All other complications, including emergent CD, low Apgar scores, low cord Ph, and neonatal intensive care unit (NICU) admission were comparable between both groups. Logistic regression, controlling for maternal age, parity, ethnicity, epidural analgesia, and gestational age, showed that the association between balloon induction and vacuum delivery is not independently significant (Table 2: adjusted OR 1.32, 95% CI 0.78-2.25, p=0.298).

Conclusion:

Balloon induction of labor at term in women with previous one CD is not  associated with obstetrical and neonatal complications.