Phuc Nhon Nguyen, Anna Ramos, Henri Marret
Background: To evaluate whether the methods of induction of labor (IOL) used for pregnancies complicated with fetal growth restriction (FGR) have different impacts on materno-fetal outcomes. Methods: This was a single-center, retrospective cohort study conducted over a one-year period, from January 2024 to December 2024, in the maternity ward of the Orléans University Hospital, France. The clinical data related to maternal-fetal characteristics and IOL outcomes were recorded. The results were comparable between the Cook® balloon and Prostaglandin groups. Results: A total of 47 patients met the inclusion criteria; 27 cases underwent the Cook® balloon and 20 cases received prostaglandin for IOL. There were no substantial differences between Cook balloon and prostaglandin on maternal-fetal characteristics and outcome of IOL. However, the duration of latent labor-delivery phase and duration of onset of labor induction and delivery were longer in the Cook® balloon group compared with the prostaglandin group (30.05 ± 10.81 versus 22.29 ± 11.94 (hours) and 7.33 ± 3.96 versus 3.74 ± 4.77 (hours), respectively, p < 0.05). The success rate according to criterion 1 (Bishop score greater than 7 after IOL) was approximately 60% (28/47 cases). However, if using criterion 2 (success by vaginal birth), after the application of two or three methods of cervical ripening with amniotomy ± use of oxytocin, the success rate increased by more than 20%, up to 80.85% (38/47 cases). Conclusions: IOL with Cook® balloon and prostaglandin may both be acceptable methods for pregnancies complicated by FGR. In addition, IOL did not differ in terms of materno-neonatal outcomes between two groups. However, the duration time from IOL to delivery and the duration from latent phase of labor to delivery were longer in the Cook® balloon group compared with the prostaglandin group.