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Am J Perinatol 2025; 42(05): 618-629
DOI: 10.1055/a-2413-3171
Original Article

Evaluation of an Outpatient Cervical Ripening Program Using Osmotic Dilators and Foley Balloon Catheters

Abbey C. Sidebottom
1   Allina Health, Minneapolis, Minnesota
,
Whitney L. Wunderlich
1   Allina Health, Minneapolis, Minnesota
,
Marc C. Vacquier
1   Allina Health, Minneapolis, Minnesota
,
Kelly A. Drake
1   Allina Health, Minneapolis, Minnesota
,
Mary P. Goering
1   Allina Health, Minneapolis, Minnesota
,
Sandra I. Hoffman
1   Allina Health, Minneapolis, Minnesota
,
David A. Watson
2   Children's of Minnesota Research Institute, Minneapolis, Minnesota
,
Laura C. Colicchia
1   Allina Health, Minneapolis, Minnesota
› Institutsangaben Funding This study was supported by the Allina Health Foundation (grant no.: 21-0053).
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Abstract

Objective

This study aimed to describe patient characteristics, satisfaction, and outcome measures for patients undergoing outpatient cervical ripening.

Study Design

A retrospective cohort study using electronic health record data from March 2020 to March 2022 from a large health system. The sample included patients with a low-risk singleton pregnancy undergoing outpatient cervical ripening with either an osmotic dilator or Foley balloon catheter. A subset of patients completed satisfaction surveys. Frequencies and means were used to describe the population and conduct comparisons by device type. Inverse probability of treatment weighted estimates were generated to address baseline differences between patients in the two device groups.

Results

Outpatient cervical ripening was completed by 120 patients (80 osmotic dilators and 40 Foley balloon catheters). The mean time from insertion to inpatient admission was 16.2 ± 4.8 hours. The mean change in simplified Bishop score (SBS) was 1.8 ± 1.4 and the mean change in dilation was 1.8 ± 1.1 cm. There were no differences in the amount of cervical change by device type. Patients returned earlier than planned 16.7% of the time, primarily for contractions or rupture of membranes. Following outpatient cervical ripening, the time from admission to delivery was 19.9 ± 10.3 hours, with no difference by device type. Vaginal delivery occurred for 74.8% of patients. Patients reported overall satisfaction with the outpatient cervical ripening experience, with the highest satisfaction among those with osmotic dilators. Patients with both device types stated they would recommend outpatient cervical ripening to others, and experienced low levels of stress and discomfort at home prior to hospital admission.

Conclusion

Patients participating in outpatient cervical ripening with osmotic dilators or Foley balloon catheters experienced clinically meaningful changes in dilation and SBSs while at home and reported general satisfaction with the outpatient program experience.

Key Points

  • Outpatient use of osmotic dilators or Foley balloon catheters improved Bishop scores.

  • Patient and device complications were comparable to other research findings.

  • Patients reported overall satisfaction with outpatient cervical ripening.

Keywords

cervical ripening - induction - Foley balloon - Dilapan-S - osmotic dilator - outpatient

Supplementary Material



Publikationsverlauf

Eingereicht: 07. Mai 2024

Angenommen: 11. September 2024

Artikel online veröffentlicht:
10. Oktober 2024

© 2024. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

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