Comparison of the efficacy and safety of dinoprostone and double-balloon catheters in cervical ripening: a propensity score matching retrospective study.

Objectives: The methods of prompting cervical ripening (CR) include mechanical and pharmacological approaches. The former seems safer. However, this superiority may change with the application of a new labor curve. Therefore, we aimed to compare the efficacy and safety of dinoprostone and double-balloon catheters (DBC) in promoting CR in induction of labor (IOL).

Material and methods: A total of 877 primipara women with Bishop score ≤ 6 were divided into the dinoprostone group (n = 502) and DBC group (n = 375) according to the IOL way. The women in the dinoprostone group received dinoprostone to perform IOL, while those in the DBC group received DBC to perform IOL. The natural birth rate, time to labor onset and birth, and maternal and neonatal complications were compared between the two groups. A propensity score match (PSM) was used to eliminate the selection bias.

Results: A total of 516 cases were left after PSM (1:1) to Bishop score. The dinoprostone was associated with an improved Bishop score. However, there were no significant differences in the vaginal delivery rate, the stage of labor, and the time from ripening to labor onset and delivery between the two groups (p > 0.05). The incidence rates of puerperal infection and blood loss were notably higher in the DBC group than in the dinoprostone group (p < 0.05). However, there was no statistical difference in the incidence of postpartum hemorrhage between the two groups (p > 0.05).

Conclusions: Dinoprostone is associated with a lower puerperal infection rate and improved Bishop score in IOL without an increased success rate of vaginal delivery.