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Induction of labor methods in isolated term oligohydramnios

  • Eyal KrispinEmail author
  • Tal Netser
  • Avital Wertheimer
  • Lina Salman
  • Rony Chen
  • Arnon Wiznitzer
  • Eran Hadar
Maternal-Fetal Medicine
  • 7 Downloads

Abstract

Objective

To compare pregnancy outcomes following induction of labor with prostaglandins versus extra-amniotic balloon catheter indicated for term isolated oligohydramnios.

Study design

Retrospective cohort study of all women who underwent induction of labor due to term isolated oligohydramnios at a university affiliated medical center (2007–2016). The cohort was divided into two subgroups, according to induction method: vaginal prostaglandins E2 versus extra-amniotic balloon catheter. Primary outcomes were successful cervical ripening, defined as a Bishop score ≥ 8, and vaginal delivery rate. Secondary outcomes were neonatal adverse events.

Results

Five hundred and ten women were included, of whom 454 (89%) underwent induction by prostaglandins and 56 (11%) by extra-amniotic balloon. Cervical ripening success rate was significantly higher in the prostaglandins group (89.4 vs. 76.79%, p = 0.006), as was the rate of vaginal delivery (77.53 vs. 48.21%, p < 0.0001). Induction with prostaglandins remained superior to extra-amniotic balloon in vaginal delivery rate following adjustment to potential confounders (aOR 3.470, 95% CI 1.296–9.296, p < 0.0001). Neonates delivered following induction with extra-amniotic balloon catheter were more often admitted to the neonatal intensive care unit (14.55 vs. 3.39%, p = 0.002).

Conclusion

Both prostaglandins and extra-amniotic balloon catheter are reasonable interventions for isolated term oligohydramnios. Prostaglandins were superior to extra-amniotic balloon both in cervical ripening success and in vaginal delivery rates.

Keywords

Induction of labor Oligohydramnios Term Prostaglandins Extra-amniotic balloon 

Abbreviations

AFI

Amniotic fluid index

PGE1

Prostaglandins E1

PGE2

Prostaglandins E2

EAB

Extra-amniotic balloon

NRFHR

Non-reassuring fetal heart rate

NICU

Neonatal intensive care unit

Notes

Author contributions

EK and EH contributed to the preliminary hypothesis, data collection, data analysis, manuscript writing and submission. TN contributed to data collection and analysis, and manuscript writing. AW and LS contributed to data collection and manuscript writing. AW and RC took part in the project development and drafts editing.

Funding

None.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

Study was approved by our local institutional review board (Approval No, 0278-17-RMC).

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required. This article does not contain any studies with animals performed by any of the authors.

References

  1. 1.
    Casey BM, McIntire DD, Bloom SL et al (2000) Pregnancy outcomes after antepartum diagnosis of oligohydramnios at or beyond 34 weeks' gestation. Am J Obstet Gynecol 182:909–912CrossRefGoogle Scholar
  2. 2.
    Apel-Sarid L, Levy A, Holcberg G, Sheiner E (2009) Placental pathologies associated with intra-uterine fetal growth restriction complicated with and without oligohydramnios. Arch Gynecol Obstet. 280:549–552CrossRefGoogle Scholar
  3. 3.
    Phelan JP, Smith CV, Broussard P, Small M (1987) Amniotic fluid volume assessment with the four-quadrant technique at 36–42 weeks’ gestation. J Reprod Med 32:540Google Scholar
  4. 4.
    Magann EF, Sandlin AT, Ounpraseuth ST (2011) Amniotic fluid and the clinical relevance of the sonographically estimated amniotic fluid volume: oligohydramnios. J Ultrasound Med. 30:1573–1585CrossRefGoogle Scholar
  5. 5.
    Ashwal E, Hiersch L, Melamed N, Aviram A, Wiznitzer A, Yogev Y (2014) The association between isolated oligohydramnios at term and pregnancy outcome. Arch Gynecol Obstet 290:875CrossRefGoogle Scholar
  6. 6.
    Hill LM, Breckle R, Wolfgram KR, O’Brien PC (1983) Oligohydramnios: ultrasonically detected incidence of subsequent outcome. Am J Obstet Gynecol 147:407–410CrossRefGoogle Scholar
  7. 7.
    Mercer LJ, Brown LJ, Petres RE, Messer RH (1984) A survey of pregnancy complicated by decreased amniotic fluid. Am J Obstet Gynecol 149:355–361CrossRefGoogle Scholar
  8. 8.
    Scwartz N, Sweeting R, Young BK (2009) Practice patterns in the management of isolated oligohydramnios:a survey of perinatologists. J Matern Fetal Neonatal Med 22:357–366CrossRefGoogle Scholar
  9. 9.
    Maoz O, Wainstock T, Sheiner E, Walfisch A (2018) Immediate perinatal outcomes of postterm deliveries. J Matern Fetal Neonatal Med. 4:1–6CrossRefGoogle Scholar
  10. 10.
    Zhang J, Troendle J, Meikle S, Klebanoff MA, Rayburn WF (2004) Isolated oligohydramnios is not associated with adverse perinatal outcomes. BJOG 111:220–225CrossRefGoogle Scholar
  11. 11.
    Venturini P, Contu G, Mazza V, Facchinetti F (2005) Induction of labor in women with oligohydramnios. Matern Fetal Neonatal Med 17:129–132CrossRefGoogle Scholar
  12. 12.
    Bishop EH (1964) Pelvic scoring for elective induction. Obstet Gynecol 24:266–268Google Scholar
  13. 13.
    ACOG Committee on Practice Bulletins-Obstetrics (2009) ACOG practice bulletin no. 107: induction of labor. Obstet Gynecol 114:386CrossRefGoogle Scholar
  14. 14.
    Eikelder T, Mast K, van der Velden A, Bloemenkamp KW, Mol BW (2016) Induction of labor using a Foley catheter or misoprostol: a systematic review and meta-analysis. Obstet Gynecol Surv 71:620–630CrossRefGoogle Scholar
  15. 15.
    Moraes Filho OB, Albuquerque RM, Cecatti JG (2010) A randomized controlled trial comparing vaginal misoprostol versus Foley catheter plus oxytocin for labor induction. Acta Obstet Gynecol Scan 89:1045–1052CrossRefGoogle Scholar
  16. 16.
    Shechter-Maor G, Haran G, Sadeh-Mestechkin D, Ganor-Paz Y, Fejgin MD, Biron-Shental T (2015) Intra-vaginal prostaglandin E2 versus double-balloon catheter for labor induction in term oligohydramnios. J Perinatol 35:95–98CrossRefGoogle Scholar
  17. 17.
    The American college of obstetricians and gynecologists (2016) Ultrasound in Pregnancy - practice bulletin no 175. Obstet Gynecol. 128:1459–1460CrossRefGoogle Scholar
  18. 18.
    Dollberg S, Haklai Z, Mimouni FB, Gorfein I, Gordon ES (2005) Birthweight standards in the live-born population in Israel. Isr Med Assoc J 7:311–314Google Scholar
  19. 19.
    Chamberlain PF, Manning FA, Morrison I et al (1984) Ultrasound evaluation of amniotic fluid volume. I: the relationship of marginal and decreased amniotic fluid volumes to perinatal outcome. Am J Obstet Gynecol 150:245CrossRefGoogle Scholar
  20. 20.
    Magann EF, Chauhan SP, Doherty DA et al (2007) The evidence for abandoning the amniotic fluid index in favor of the single deepest pocket. Am J Perinatol. 24:549–555CrossRefGoogle Scholar
  21. 21.
    Hashimoto K, Kasdaglis T, Jain S et al (2013) Isolated low-normal amniotic fluid volume in the early third trimester: association with adverse perinatal outcomes. J Perinat Med. 41:349CrossRefGoogle Scholar
  22. 22.
    Grobman WA, Rice MM, Reddy UM et al (2018) Labor induction versus expectant management in low-risk nulliparous women. N Engl J Med. 379:513CrossRefGoogle Scholar
  23. 23.
    Practice Advisory 2018 Clinical guidance for integration of the findings of the ARRIVE trial: labor induction versus expectant management in low-risk nulliparous women. https://www.acog.org/Clinical-Guidance-and-Publications/Practice-Advisories/Practice-Advisory-Clinical-guidance-for-integration-of-the-findings-of-The-ARRIVE-Trial. Accessed on 09 Aug 2018.
  24. 24.
    Maul H, Mackay L, Garfield RE (2006) Cervical ripening: biochemical, molecular, and clinical considerations. Clin Obstet Gynecol. 49:551–563CrossRefGoogle Scholar
  25. 25.
    Kelly AJ, Kavanagh J, Thomas J. Vaginal prostaglandin (PGE2 and PGF2a) for induction of labour at term. Cochrane Database Syst Rev. 2009;4.Google Scholar
  26. 26.
    Lim CED, Ng RWC, Xu K (2013) Non-hormonal methods for induction of labour. Curr Opin Obstet Gynecol 25:441–447CrossRefGoogle Scholar
  27. 27.
    Sarno AP Jr, Ahn MO, Phelan JP. Intrapartum amniotic fluid volume at term. Association of ruptured membranes, oligohydramnios and increased fetal risk. J Reprod Med. 1990; 35:719–723.Google Scholar
  28. 28.
    Vaknin Z, Kurzweil Y, Sherman D (2010) Foley catheter balloon vs locally applied prostaglandins for cervical ripening and labor induction: a systematic review and metaanalysis. Am J Obstet Gynecol. 203:418CrossRefGoogle Scholar
  29. 29.
    Granstrom L, Ekman G, Ulmsten U (1992) Myometrial activity after local application of prostaglandin E 2 for cervical ripening and term labor induction. Am J Obster Gynecol 162:691–694CrossRefGoogle Scholar
  30. 30.
    Levine EM, Ghai V, Barton JJ et al (2001) Mode of delivery and risk of respiratory diseases in newborns. Obstet Gynecol 97:439–442CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Rabin Medical CenterHelen Schneider Hospital for WomenPetach TikvaIsrael
  2. 2.Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael

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