Evidence Based Birth®

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


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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.

For more information and news about Evidence Based Birth®, visit www.ebbirth.com. Find us on Facebook (https://www.facebook.com/EvidenceBasedBirth/), Instagram (https://www.instagram.com/ebbirth/), and Pinterest (https://www.pinterest.com/ebbirth/). Ready to get involved? Check out our Professional membership (including scholarship options) (https://evidencebasedbirth.com/become-pro-member/). Find an EBB Instructor here (https://evidencebasedbirth.com/find-an-instructor-parents/), and click here (https://evidencebasedbirth.com/childbirth-class/) to learn more about the Evidence Based Birth® Childbirth Class.

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Evidence Based Birth®By Rebecca Dekker, PhD, RN

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