Balloon Catheter for Induction of Labor in Nulliparous Women with Prelabor Rupture of the Membranes at Term

The balloon catheter method has been described as an effective method for cervical ripening hitherto used exclusively before rupture of the membranes. We found it of interest to perform a pilot study of the balloon catheter method after rupture of the membranes. In 18 nulliparous women, with an unripe cervix (Bishop score < or = 5) 48 h after prelabor rupture of the membranes at term, cervical ripening was performed using a 26-gauge balloon catheter. Seventy six percent of these women delivered vaginally. Clinical and neonatal outcome data did not differ as compared with term pregnant women who entered labor spontaneously or had a ripe cervix (Bishop score >5) and labor induced with oxytocin within 48 h after prelabor rupture of the membranes. Despite visualization of a pool of amniotic fluid in the vagina on speculum examination on admission, there was a high proportion of patients with an intact forebag observed during the birth process. This preliminary report indicates that the balloon catheter method might be a well-tolerated, safe, and effective method for induction of labor after rupture of the membranes at term.