Circadian Chronobiology of Cervical Ripening Balloon Insertion: Effects on Labor Progression and Maternal Outcomes
Placing a cervical balloon before noon may shorten the first stage of labor and reduce postpartum hemorrhage risk, suggesting a need for morning placements when feasible.
Where it sits
this study against the rest of the oxytocin corpusSummary and findings
The study measured the effects of cervical balloon placement time on labor duration and maternal outcomes in 193 pregnant women. The women were divided into two groups based on balloon placement before or after 12:00. Significant differences were observed in labor progression and postpartum hemorrhage rates between the groups.
Abstract
<title>Abstract</title> <p> <bold>Objective</bold> To investigate the effects of different placement times of cervical balloon (before 12:00 vs. after 12:00) on labor duration, oxytocin use, mode of delivery, and maternal and neonatal outcomes. <bold>Methods</bold> A total of 193 singleton, cephalic, full-term pregnant women with unfavorable cervix (Bishop score < 6) who were scheduled for delivery in Beijing Tongren Hospital from January 2024 to March 2026 were enrolled. According to the balloon placement time, they were divided into study group 1 (before or at 12:00, 112 cases) and study group 2 (after 12:00, 81 cases). The indicators of labor duration, oxytocin use, mode of delivery, postpartum hemorrhage and neonatal outcomes were compared between the two groups. <bold>Results</bold> There was no significant difference in vaginal delivery rate between the two groups (P = 0.132). In the vaginal delivery subgroup, the time from balloon placement to expulsion/removal, the time from induction to active labor, and the duration of the first stage of labor in study group 1 were significantly shorter than those in study group 2 (P < 0.05). The incidence of postpartum hemorrhage (> 500 ml) in study group 1 was significantly lower than that in study group 2 (5.5% vs. 16.4%, P = 0.040). No significant differences were found in the second stage, third stage, total stage of labor, oxytocin use rate, and neonatal outcomes between the two groups (P > 0.05). <bold>Conclusion</bold> Placing cervical balloon in the morning (before 12:00) can shorten the first stage of labor, accelerate cervical ripening and reduce the risk of postpartum hemorrhage. It is recommended to prioritize morning placement when conditions permit. </p>
Background
Not reported in abstract.
Methods
Not reported in abstract.
Results
Not reported in abstract.
Interpretation
Not reported in abstract.
Limitations
Not reported in abstract.