Setting of Induction of Labour with Double-Balloon Catheter in Low-risk Pregnancies: Outpatient Versus Inpatient

Abstract

Objectives

Induction of labour is one of the most frequently performed obstetric procedures. This analysis aimed to assess maternal and neonatal outcomes after labour induction with a double-balloon catheter in an outpatient versus inpatient setting in low-risk term pregnancies.

Methods

In this retrospective cohort study, 1010 women with singleton, low-risk term pregnancies undergoing labour induction with a double-balloon catheter were analysed. Of these, 394 received outpatient and 616 inpatient cervical ripening. The primary outcome was the caesarean section rate; secondary outcomes included the induction-to-delivery interval, vaginal delivery within 24 hours and neonatal parameters.

Results

Delivery modes were comparable between groups (p = 0.5524), but vaginal delivery within 24 hours occurred less frequently in the outpatient group (25.2% vs. 32.9%, p = 0.0201). Neonatal outcomes were significantly better in the outpatient cohort, with lower rates of arterial umbilical cord pH < 7.10 (2.0% vs. 5.5%, p = 0.0067) and NICU admissions (6.9% vs. 15.1%, p < 0.0001). Multiple logistic regression analysis identified nulliparity (OR = 10.545), maternal age (OR = 1.076), and birth weight (OR = 1.733) as significant predictors for caesarean section. Failure to achieve vaginal delivery within 24 hours was associated with higher BMI (OR = 1.080), nulliparity (OR = 4.191), and fetal macrosomia (OR = 3.675), while labour onset by balloon catheter alone reduced this risk (OR = 0.149). Outpatient induction was associated with a lower risk of arterial pH < 7.10 (OR = 0.352, p = 0.0088).

Conclusions

Outpatient cervical ripening with a double-balloon catheter is a safe and effective alternative to inpatient induction in low-risk term pregnancies, with comparable delivery outcomes and potential neonatal benefits.

Zusammenfassung

Zielsetzung

Die Geburtseinleitung stellt eines der am häufigsten durchgeführten Verfahren in der Geburtshilfe dar. Ziel dieser Analyse war es, die mütterlichen und neonatalen Outcomes nach einer Geburtseinleitung mit Doppelballonkatheter, die bei Niedrig-Risiko-Schwangerschaften in einem stationären oder ambulanten Setting durchgeführt wurde, zu evaluieren.

Methoden

In dieser retrospektiven Kohortenstudie wurden 1010 Frauen mit Niedrig-Risiko-Einlingsschwangerschaften, die sich einer Geburtseinleitung mit einem Doppelballonkatheter unterzogen, analysiert. Bei 394 der Frauen wurde die zervikale Reifung ambulant durchgeführt, und bei 616 der Frauen wurde sie stationär durchgeführt. Das primäre Outcome war die Sectio-Rate; sekundäre Outcomes waren Dauer zwischen Einleitung und Geburt, vaginale Entbindung innerhalb von 24 Stunden und neonatale Parameter.

Ergebnisse

Die Entbindungsarten in den 2 Gruppen waren vergleichbar (p = 0,5524), aber bei der ambulanten Gruppe fand eine vaginale Entbindung innerhalb von 24 Stunden weniger oft statt als in der stationären Gruppe (25,2% vs. 32,9%, p = 0,0201). Die neonatalen Ergebnisse waren signifikant besser in der ambulanten Kohorte, mit niedrigeren Raten von Nabelschnur-pH-Werten < 7,10 (2,0% vs. 5,5%, p = 0,0067) und Aufnahmen in einer neonatalen Intensivstation (6,9% vs. 15,1%, p < 0,0001). Bei der mehrfachen logistischen Regressionsanalyse wurden Nulliparität (OR = 10,545), mütterliches Alter (OR = 1,076) und Geburtsgewicht (OR = 1,733) als signifikante Prädiktoren für eine Sectio ermittelt. Keine vaginale Entbindung innerhalb von 24 Stunden nach Einleitung war mit einem höheren BMI (OR = 1,080), Nulliparität (OR = 4,191) und fetaler Makrosomie (OR = 3,675) assoziiert, wohingegen dieses Risiko durch eine Geburtseinleitung nur mithilfe eines Ballonkatheters reduziert wurde (OR = 0,149). Die ambulante Einleitung war mit einem niedrigeren Risiko von einem Nabelschnur-pH-Wert < 7,10 assoziiert (OR = 0,352, p = 0,0088).

Schlussfolgerung

Die ambulante zervikale Reifung mit einem Doppelballonkatheter stellt eine sichere und effektive Alternative zur stationären Geburtseinleitung bei Frauen mit Niedrig-Risiko-Schwangerschaften dar. Die Geburtsergebnisse und potenziellen neonatalen Vorteile waren vergleichbar.

Keywords

delivery - induction of labor - balloon catheter - setting - outpatient - inpatient

Schlüsselwörter

Entbindung - Geburtseinleitung - Ballonkatheter - Setting - ambulant - stationär

Publication History

Received: 25 October 2025

Accepted after revision: 25 December 2025

Article published online:
29 January 2026

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