Comparison of Materno-Neonatal Outcomes Between Cook Balloon and Prostaglandin Methods in Labor Induction Among Pregnancies Complicated by Fetal Growth Restriction: A Retrospective Cohort Study from France

Background: To evaluate whether the methods of induction of labor (IOL) used for pregnancies complicated with fetal growth restriction (FGR) have different impacts on materno-fetal outcomes. Methods: This was a single-center, retrospective cohort study conducted over a one-year period, from January 2024 to December 2024, in the maternity ward of the Orléans University Hospital, France. The clinical data related to maternal–fetal characteristics and IOL outcomes were recorded. The results were comparable between the Cook® balloon and Prostaglandin groups. Results: A total of 47 patients met the inclusion criteria; 27 cases underwent the Cook® balloon and 20 cases received prostaglandin for IOL. There were no substantial differences between Cook balloon and prostaglandin on maternal–fetal characteristics and outcome of IOL. However, the duration of latent labor-delivery phase and duration of onset of labor induction and delivery were longer in the Cook® balloon group compared with the prostaglandin group (30.05 ± 10.81 versus 22.29 ± 11.94 (hours) and 7.33 ± 3.96 versus 3.74 ± 4.77 (hours), respectively, p < 0.05). The success rate according to criterion 1 (Bishop score greater than 7 after IOL) was approximately 60% (28/47 cases). However, if using criterion 2 (success by vaginal birth), after the application of two or three methods of cervical ripening with amniotomy ± use of oxytocin, the success rate increased by more than 20%, up to 80.85% (38/47 cases). Conclusions: IOL with Cook® balloon and prostaglandin may both be acceptable methods for pregnancies complicated by FGR. In addition, IOL did not differ in terms of materno-neonatal outcomes between two groups. However, the duration time from IOL to delivery and the duration from latent phase of labor to delivery were longer in the Cook® balloon group compared with the prostaglandin group.