Outpatient Cervical Ripening Safely Shortens Inpatient Labor

The researchers also observed a significant 24% decreased risk of cesarean delivery, and no stillbirths were reported. Demographically, body mass index (BMI) was lower in the outpatient group, with no differences in maternal age, gestational age at induction, or parity. The study was published on January 6, 2022, in Obstetrics & Gynecology.

“We knew induction was good in the hospital for many indications. We now know that induction can be started at home, and it's safe,” said corresponding author Vincenzo Berghella, MD, director of the maternal-fetal medicine at TJU. “The lower rate of cesarean delivery in the outpatient group likely reflected less use of fetal heart-rate monitoring, which can produce false-positive predictions of fetal compromise.”

Balloon catheters have been used for labor induction as far back as the 1890s. It has been postulated that the mechanical stretching by the catheter balloon causes an increased release of endogenous prostaglandins, which in turn cause cervical ripening, and without significant uterine contractions or systemic side effects in mothers. Expulsion of the balloon catheter usually occurs when a cervical dilation of about four cm is evident.

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