ArticleGeburtshilfe und Frauenheilkunde2026
Oral Misoprostol +/- Double-Balloon Catheter Versus Vaginal Insertion of Dinoprostone for Induction of Labour at Full-Term.
Article in Geburtshilfe und Frauenheilkunde, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: Following the approval of an oral misoprostol preparation for labour induction in 2020, the previous procedure using a vaginal dinoprostone insert was replaced in Klagenfurt by oral misoprostol, with or without a double-balloon catheter (CRB - Cervical Ripening Balloon). The aim of this study was to compare the two methods in terms of effectiveness, safety and cost. Materials and Methods: In a retrospective analysis, births from 37w+0d of gestation between September 2021 and August 2023 (misoprostol with or without CRB) were compared with the period from September 2018 to August 2020 (dinoprostone). The primary endpoint was the caesarean section rate. Secondary endpoints included perinatal outcome, duration of induction, complications, length of hospital stay, frequency of cardiotocography (CTG) monitoring and costs. Results: A total of 1011 cases were analysed in this study. Overall, the caesarean section rate did not differ significantly (26.8% in 2018-2020 vs. 23.9% in 2021-2023, p = 0.31). However, in the subgroup of first-time mothers without ruptured membranes, there was a significant reduction in the caesarean section rate in favour of CRB + misoprostol (45.3% vs. 34.4%, p = 0.02). Perinatal outcomes, complications and length of hospital stay were comparable. The duration of induction was significantly longer with CRB + misoprostol (18.2 hours vs. 25.5 hours, p < 0.01). With the sequential approach, more CTG checks were carried out (5.6 vs. 6.6, p < 0.01). The sequential regimen of CRB and misoprostol was, on average, € 9 more expensive per patient than induction using the dinoprostone vaginal insert alone. Conclusion: The combination of CRB and misoprostol is a safe and effective method of inducing labour. Despite a longer induction duration, the length of inpatient stay remains unchanged. In first-time mothers without rupture of membranes, it results in fewer caesarean sections compared with dinoprostone vaginal insert.
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