Poster Session 1
Category: Labor
Poster Session 1
Sonya Fabricant, MD (she/her/hers)
Maternal-Fetal Medicine Fellow
Cedars-Sinai Medical Center
Los Angeles, California, United States
Camelita Thrift, MD
Resident
Department of Obstetrics & Gynecology, Cedars-Sinai Medical Center
Los Angeles, California, United States
Lauren McCarthy, MD
Department of Obstetrics & Gynecology, Cedars-Sinai Medical Center
Los Angeles, California, United States
Glenda Marshall, MD
Department of Obstetrics & Gynecology, Cedars-Sinai Medical Center
Los Angeles, California, United States
Mackenzie Bennett, MD
Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center
Los Angeles, California, United States
Mariam Naqvi, MD (she/her/hers)
Associate Professor, Maternal Fetal Medicine
Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center
Los Angeles, California, United States
Naomi H. Greene, MPH, PhD (she/her/hers)
Assistant Professor, Research Track
Department of Obstetrics & Gynecology, Cedars-Sinai Medical Center
Los Angeles, California, United States
Emily Seet, MD
Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center
Los Angeles, California, United States
This was a retrospective cohort study of individuals undergoing induction of labor at a quaternary care center (delivery date 8/1/2024–6/27/2025). Cases had oFB placement. Controls underwent inpatient cervical ripening via foley ballon (FB) plus prostaglandin E1, prostaglandin E2 or oxytocin. Inclusion criteria were nulliparity, singleton gestation, delivery gestational age 39w0d–41w6d, cervical dilation ≤ 3cm at FB placement and low-risk pregnancy. The primary outcome was time from admission to delivery. Secondary outcomes were time to delivery < 24 hours, cesarean delivery, hospital length of stay, blood loss, clinical diagnosis of intrauterine infection, 5-minute APGAR < 7, umbilical artery pH < 7 or base deficit ≥ 12 and NICU admission. Baseline characteristics and outcomes were compared between groups. Our study was powered to detect a 6-hour difference in time to delivery using a two-tailed test with an alpha level of 0.05 and 80% power.
Results:
Of 197 eligible individuals, 31 (15.7%) underwent oFB placement. Baseline characteristics did not differ between cases and controls (Table 1). Cases had greater admission cervical dilation (3.8 vs 1.1 cm, p < 0.0001) and Bishop score (6.5 vs 4.6, p < 0.001). However, cases had longer duration of oxytocin administration (20.3 vs 17.0 hours, p=0.04) and ruptured membranes (15.6 vs 12.2 hours, p = 0.02) (Table 2). Time to delivery was similar between cases and controls (22.8 vs 22.2 hours, p = 0.72). There was no statistically significant difference in cesarean delivery rates (cases 16.1% vs controls 20.5%, p= 0.58). Remaining maternal and neonatal outcomes were also similar.
Conclusion:
Among low-risk nulliparous individuals undergoing term induction of labor, oFB placement did not reduce time to delivery compared to inpatient combined cervical ripening methods, despite a more favorable Bishop score at admission. Larger studies are needed to determine if oFB impacts cesarean delivery rate.