EBB 153 – Pros and Cons of the Foley and Dilapan-S® for Cervical Ripening During an Induction

Evidence Based Birth®

Rebecca Dekker

Pregnancy, Health & Fitness, Childbirth, Parenting, Birth, Medicine, Kids & Family, Doula, Obstetrician, Midwife

4.6 • 978 Ratings

🗓️ 18 November 2020

⏱️ 28 minutes

🔗️ Recording | iTunes | RSS

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Summary

In this episode, I will talk about cervical ripening, the Bishop score, and some "mechanical" ways to ripen the cervix. More specifically, we'll talk about the advantages and disadvantages of cervical osmotic dilators (including Dilapan-S®), and using the Foley balloon for cervical ripening.

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References on Cervical Ripening:

Curran, M. (2020). Bishop Score Calculator. Click here.
Kolkman, D. G. E., Verhoeven, C. J. M., Brinkhorst, S. J., et al. (2013). Bishop score as a predictor of labor induction success: a systematic review. American Journal of Perinatology, 30(8), 625-30. Click here.
Ivars, J., Garabedian, C., Devos, P., et al. (2016). Simplified Bishop score including parity predicts successful induction of labor. Eur J Obstet Gynecol Reprod Biol., 203, 309-314. Click here.

References on the Foley:

Abdelhakim, A. M. Shareef, M .A., AlAmodi, A. A., et al. (2020). Outpatient versus inpatient balloon catheter insertion for labor induction: A systematic review and meta-analysis of randomized controlled trials. Journal of Gynecology Obstetrics and Human Reproduction, In Press. Click here.
Alfirevic, Z., Keeney, E., Dowswell, T., et al. (2016). Methods to induce labour: a systematic review, network meta-analysis and cost-effectiveness analysis. BJOG., 123(9), 1462-1470. Click here.
American College of Obstetricians and Gynecologists (2009, Reaffirmed 2019). ACOG Practice Bulletin No. 107: Induction of labor. Obstet Gynecol.,114(2 Pt 1), 386-397. Click here.
de Vaan, M. D. T., ten Eikelder, M. L. G., Jozwiak, M., et al. (2019). Mechanical methods for induction of labour. Cochrane Database of Systematic Reviews 2019, Issue 10. Art. No.: CD001233. Click here.
Dong, S., Khan, M., Hashimi, F., et al. (2020). Inpatient versus outpatient induction of labour: a systematic review and meta-analysis. BMC pregnancy and childbirth, 20(1), 382. Click here.
Leduc, D., Biringer, A., Lee, L., et al. (2013). Induction of Labor: SOGC Clinical Practice Guideline. No. 296, 35(9), 840-857. Click here.
Liu, X., Wang, Y., Zhang, F., et al. (2019). Double- versus single-balloon catheters for labour induction and cervical ripening: a meta-analysis. BMC pregnancy and childbirth, 19(1), 358. Click here.
Simpson, K. R. (2020). Cervical Ripening and Labor Induction and Augmentation, 5th Edition. AWHONN Practice Monograph, 24(4), PS1-S41. Click here.

References on Dilapan-S:

American College of Obstetricians and Gynecologists (2009, Reaffirmed 2019). ACOG Practice Bulletin No. 107: Induction of labor. Obstet Gynecol.,114(2 Pt 1), 386-397. Click here.
Levine, L. D., Valencia, C. M. and Tolosa, J. E. (2020). Induction of labor in continuing pregnancies. Best Pract Res Clin Obstet Gynaecol., S1521-6934(20), 30079-1. Click here.
Gupta, J., Chodankar, R., Baev, O., et al. (2018). Synthetic osmotic dilators in the induction of labour-An international multicentre observational study. Eur J Obstet Gynecol Reprod Biol., 229, 70-75. Click here.
Saad, A. F., Villarreal, J., Eid, J., et al. (2019). A randomized controlled trial of Dilapan-S vs Foley balloon for preinduction cervical ripening (DILAFOL trial). Am J Obstet Gynecol., 220(3), 275.e1-275.e9. Click here.

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Transcript

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0:00.0	Hi everyone on today's episode we're going to talk about the options of using
0:04.3	dial-a-pan S and the Foley for cervical ripening during a medical labor induction.
0:18.5	Welcome to the Evidence Based Birth Podcast. My name is Rebecca Decker and I'm a nurse with my PhD and the founder of Evidence Space Birth. Join me each week as we work together to get evidence-based information into the hands of
0:27.2	families and professionals around the world.
0:30.5	As a reminder, this information is not medical advice.
0:33.5	See EB Birth.com slash disclaimer for more details.
0:38.0	Hi everyone and welcome to today's episode of the evidence space birth
0:44.1	podcast. Today we're going to talk about cervical ripening, the Bishop
0:48.6	score, and some mechanical ways to ripen the cervix. This episode is going to wrap up the
0:55.2	series we've been doing this year. We started talking about natural induction
0:59.9	methods focusing on one new method per month on the podcast.
1:04.8	And then two episodes ago in episode 151, we talked about membrane stripping, which actually
1:09.8	is a mechanical method of cervical ripening. We're going to expand on that topic in this
1:14.4	podcast. Whenever you have a formal medical labor induction it usually involves two
1:19.8	steps. First, cervical ripening is done to physically soften and eventually thin and
1:25.1	dilate the cervix in preparation for labor and vaginal birth. Second, when
1:29.7	the cervix is favorable, labor induction stimulates uterine contractions artificially to promote the start of labor.
1:37.0	Clinicians often use the Bishop's score to determine if cervical ripening is beneficial before an induction.
1:44.9	The Bishop score is based on results from a vaginal exam that uses five measurements to determine
1:50.5	the readiness of the cervix for labor,
1:52.5	which sometimes people call cervical ripeness.
1:55.9	Servical dilation is the measure of how dilated
	...

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