Cervical Ripening with a Balloon? Add Oxytocin Now, Not Later

Given the large number of labor inductions now performed in the U.S. annually, improving the efficiency and safety of the procedure will translate into ample saved time and averted complications; however, the question of whether to start oxytocin during or after cervical ripening with a Foley balloon remains open. Investigators at two diverse U.S. health systems conducted a trial of concurrent versus sequential oxytocin among 184 nulliparous and 139 multiparous women undergoing labor induction with intracervical balloons filled with saline. Participants were randomized to receive oxytocin starting within 1 hour of Foley balloon placement (concurrent) or after the balloon was expelled or removed (delayed).

Both nulliparous and multiparous wom…