{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T14:10:08Z","timestamp":1773324608390,"version":"3.50.1"},"reference-count":24,"publisher":"Georg Thieme Verlag KG","issue":"03","license":[{"start":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T00:00:00Z","timestamp":1769644800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Geburtshilfe Frauenheilkd"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Induction of labour is one of the most frequently performed obstetric procedures. This analysis aimed to assess maternal and neonatal outcomes after labour induction with a double-balloon catheter in an outpatient versus inpatient setting in low-risk term pregnancies.<\/jats:p>\n                  <jats:p>In this retrospective cohort study, 1010 women with singleton, low-risk term pregnancies undergoing labour induction with a double-balloon catheter were analysed. Of these, 394 received outpatient and 616 inpatient cervical ripening. The primary outcome was the caesarean section rate; secondary outcomes included the induction-to-delivery interval, vaginal delivery within 24 hours and neonatal parameters.<\/jats:p>\n                  <jats:p>Delivery modes were comparable between groups (p\u00a0=\u00a00.5524), but vaginal delivery within 24 hours occurred less frequently in the outpatient group (25.2% vs. 32.9%, p\u00a0=\u00a00.0201). Neonatal outcomes were significantly better in the outpatient cohort, with lower rates of arterial umbilical cord pH &lt;\u00a07.10 (2.0% vs. 5.5%, p\u00a0=\u00a00.0067) and NICU admissions (6.9% vs. 15.1%, p\u00a0&lt;\u00a00.0001). Multiple logistic regression analysis identified nulliparity (OR =\u00a010.545), maternal age (OR =\u00a01.076), and birth weight (OR =\u00a01.733) as significant predictors for caesarean section. Failure to achieve vaginal delivery within 24 hours was associated with higher BMI (OR =\u00a01.080), nulliparity (OR =\u00a04.191), and fetal macrosomia (OR =\u00a03.675), while labour onset by balloon catheter alone reduced this risk (OR =\u00a00.149). Outpatient induction was associated with a lower risk of arterial pH &lt;\u00a07.10 (OR =\u00a00.352, p\u00a0=\u00a00.0088).<\/jats:p>\n                  <jats:p>Outpatient cervical ripening with a double-balloon catheter is a safe and effective alternative to inpatient induction in low-risk term pregnancies, with comparable delivery outcomes and potential neonatal benefits.<\/jats:p>","DOI":"10.1055\/a-2780-1607","type":"journal-article","created":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T23:49:27Z","timestamp":1769730567000},"page":"281-288","source":"Crossref","is-referenced-by-count":0,"title":["Setting of Induction of Labour with Double-Balloon Catheter in Low-risk Pregnancies: Outpatient Versus Inpatient"],"prefix":"10.1055","volume":"86","author":[{"given":"Sven","family":"Kehl","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, LMU University Hospital, LMU Munich, Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne","family":"Gernhardt","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology, Erlangen University Hospital, Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christel","family":"Weiss","sequence":"additional","affiliation":[{"name":"Department of Medical Statistics and Biomathematics, University Medical Centre Mannheim, Mannheim, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael O.","family":"Schneider","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology, Erlangen University Hospital, Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthias W.","family":"Beckmann","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology, Erlangen University Hospital, Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6174-5650","authenticated-orcid":false,"given":"Jutta","family":"Pretscher","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology, Erlangen University Hospital, Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2026,1,29]]},"reference":[{"issue":"03","key":"ref1","doi-asserted-by":"publisher","first-page":"CD001233","DOI":"10.1002\/14651858.CD001233.pub4","article-title":"Mechanical methods for induction of labour","author":"MD de Vaan","year":"2023","journal-title":"Cochrane Database Syst Rev"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"870","DOI":"10.1055\/a-1519-7713","article-title":"Induction of Labour. Guideline of the DGGG, OEGGG and SGGG (S2k, AWMF Registry No. 015\u2013088, December 2020)","volume":"81","author":"S Kehl","year":"2021","journal-title":"Geburtshilfe Frauenheilkd"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1007\/s00404-021-06090-y","article-title":"Multicentre randomised controlled trial comparing the safety in the first 12\u00a0h, efficacy and maternal satisfaction of a double balloon catheter and prostaglandin pessary for induction of labour","volume":"305","author":"YH Grace Ng","year":"2022","journal-title":"Arch Gynecol Obstet"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"891","DOI":"10.1111\/1471-0528.14256","article-title":"Double-balloon catheter versus prostaglandin E2 for cervical ripening and labour induction: a systematic review and meta-analysis of randomised controlled trials","volume":"124","author":"YM Du","year":"2017","journal-title":"BJOG"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1443","DOI":"10.1111\/j.1471-0528.2009.02279.x","article-title":"Induction of labour in nulliparous women with an unfavourable cervix: a randomised controlled trial comparing double and single balloon catheters and PGE2 gel","volume":"116","author":"CE Pennell","year":"2009","journal-title":"BJOG"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1681","DOI":"10.1016\/S0140-6736(22)01845-1","article-title":"Balloon catheters versus vaginal prostaglandins for labour induction (CPI Collaborative): an individual participant data meta-analysis of randomised controlled trials","volume":"400","author":"MN Jones","year":"2022","journal-title":"Lancet"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1016\/j.ejogrb.2011.09.010","article-title":"Combination of misoprostol and mechanical dilation for induction of labour: a randomized controlled trial","volume":"159","author":"S Kehl","year":"2011","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"238","DOI":"10.1055\/s-0035-1545899","article-title":"Induction of Labour: Change of Method and its Effects","volume":"75","author":"S Kehl","year":"2015","journal-title":"Geburtshilfe Frauenheilkd"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"3453","DOI":"10.1080\/14767058.2019.1574741","article-title":"Misoprostol combined with cervical single or double balloon catheters versus misoprostol alone for labor induction of singleton pregnancies: a meta-analysis of randomized trials","volume":"33","author":"L Ornat","year":"2020","journal-title":"J Matern Fetal Neonatal Med"},{"issue":"S 3","key":"ref11","doi-asserted-by":"publisher","first-page":"S696","DOI":"10.1016\/j.ajog.2022.01.005","article-title":"Single-balloon catheter with concomitant vaginal misoprostol is the most effective strategy for labor induction: a meta-review with network meta-analysis","volume":"230","author":"L Sanchez-Ramos","year":"2024","journal-title":"Am J Obstet Gynecol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1016\/j.ejogrb.2016.07.507","article-title":"Double-balloon catheter and sequential oral misoprostol versus oral misoprostol alone for induction of labour at term: a retrospective cohort study","volume":"204","author":"S Kehl","year":"2016","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"382","DOI":"10.1186\/s12884-020-03060-1","article-title":"Inpatient versus outpatient induction of labour: a systematic review and meta-analysis","volume":"20","author":"S Dong","year":"2020","journal-title":"BMC Pregnancy Childbirth"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"574","DOI":"10.1111\/birt.12568","article-title":"Outpatient Foley catheter induction protocol provides clinical and cost benefits","volume":"48","author":"MC Washburn","year":"2021","journal-title":"Birth"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1619","DOI":"10.1016\/S0140-6736(16)00084-2","article-title":"Induction of labour at term with oral misoprostol versus a Foley catheter (PROBAAT-II): a multicentre randomised controlled non-inferiority trial","volume":"387","author":"ML Ten Eikelder","year":"2016","journal-title":"Lancet"},{"issue":"08","key":"ref16","doi-asserted-by":"publisher","first-page":"CD007372","DOI":"10.1002\/14651858.CD007372.pub4","article-title":"Home versus inpatient induction of labour for improving birth outcomes. Cochrane Pregnancy and Childbirth Group","author":"Z Alfirevic","year":"2020","journal-title":"Cochrane Database Syst Rev"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"1091","DOI":"10.1097\/AOG.0000000000004382","article-title":"Outpatient Cervical Ripening: A Systematic Review and Meta-analysis","volume":"137","author":"M McDonagh","year":"2021","journal-title":"Obstet Gynecol"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"996","DOI":"10.1055\/a-2096-1182","article-title":"Fetal Assessment in Pregnancy (Indication and Methodology for Fetal Monitoring in a Low-risk Population). 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