What is the volume of a Cook's (intrauterine) balloon in labor and delivery?

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Last updated: April 26, 2025View editorial policy

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From the Research

The recommended volume of Cook's balloon in labor and delivery is 80 mL, as it has been shown to be more effective in cervical ripening and labor induction compared to smaller volumes. This is based on the study by 1, which found that a larger balloon volume of 80 mL resulted in a significantly higher rate of post-ripening dilatation of 3 cm or more, and a significantly less requirement of augmentation with oxytocin. The use of Cook's balloon, also known as a cervical ripening balloon or Foley catheter, is a common method for labor induction, and the volume of the balloon can vary depending on clinical circumstances and hospital protocols.

Key Points

  • The most common volume used for Cook's balloon is 30-80 mL of sterile water or saline.
  • The balloon works by applying mechanical pressure on the cervix, stimulating the release of prostaglandins that help soften and dilate the cervix.
  • The balloon is usually left in place for 12-24 hours or until it spontaneously falls out, which typically indicates that the cervix has dilated to approximately 3-4 cm.
  • Patients may experience mild cramping or discomfort during placement, but this method generally has fewer systemic side effects compared to pharmacological methods of labor induction.

Clinical Considerations

  • Healthcare providers should follow their institution's specific guidelines for inflation volume and duration.
  • The choice of volume may depend on the individual patient's clinical circumstances, such as the presence of any medical conditions or the stage of labor.
  • The use of Cook's balloon should be monitored closely to minimize the risk of complications, such as uterine rupture or fetal distress, as noted in studies such as 2 and 3. However, the most recent and highest quality study 1 supports the use of 80 mL as a safe and effective volume.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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