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Compared with expectant management, induction of labor at 39 weeks of gestation has been associated with lower rates of cesarean delivery (NEJM JW Womens Health Sep 2018 and N Engl J Med 2018; 379:513), an outcome that has led to an increase in rates of induction at 39 weeks. At this gestation, the cervix is often long and closed, a finding unfavorable with initiating induction; thus, cervical ripening with a double-balloon catheter for 12 hours is commonly employed. To investigate the efficacy of shorter-duration ripening, investigators in Israel studied labor outcomes following randomization of 243 nulliparous and parous women undergoing labor induction to 6 or 12 hours of double-balloon catheter cervical ripening.
Among the nulliparous wo…