Effects of double balloon and dinoprostone induction of labour and factors affecting vaginal delivery in primipara: An analysis of large, single-center clinical data

Abstract Objective: To compare the effects of double balloon (DB) and dinoprostone induction of labor (IOL) and identify relevant factors affecting vaginal delivery in primipara with a cervical bishop score <6. Methods: A total of 636 eligible primiparas with a cervical bishop score <6 were recruited for retrospective case-control analysis,who were divided into two groups, including double balloon group (DBG) (n=474) and dinoprostone group (DG) (n=162), and the basic clinical data of the two groups were collected for comparison. If labour is not progressing or there are no effective contractions, oxytocin is used after intervention. Univariate and multivariate models were used to assess factors influencing vaginal delivery (VD) and VD within 24 hours. Results: The rates of uterine hyperstimulation and deciding to caesarean section (CS) after IOL within 12 hours were higher in DG ( p<0.001,p=0.022,respectively ), and the rates of duration of labor within 12 hours and emergency delivery DG had a higher rate of duration of labor within 12 hours were higher in DG (both p<0.001).However,oxytocin augmentation was significantly higer in DBG (p<0.001). Multivariate regression analysis shows that bishop Score (p<0.001, OR=5.119, 95%CI 2.539-10.320), birth weight (P<0.001, OR=0.994, 95%CI 0.992-0.996), and obstetric analgesia (P=0.002, OR=5.402, 95%CI 1.816-16.068) were risk factors for VD.Moreover,bishop Score (p=0.024, OR=1.718, 95%CI 1.075-2.748),obstetric analgesia (P=0.013, OR=3.072, 95%CI 1.270-7.413),oxytocin augmentation (p=0.026, OR=0.382, 95%CI 0.164-0.892) were independent influencing factors for VD within 24 hours. Conclusion: The effect of IOLwithin 24 hours was equivalent between DBG and DG. DBG appears to bea little more superior when considering the complication of IOL, but oxytocin augmentation should also be considered. Bishop Score,obstetric analgesia and oxytocin augmentation were independent influencing factors for VD within 24 hours.