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Meta-Analysis
. 2017 May;124(6):891-899.
doi: 10.1111/1471-0528.14256. Epub 2016 Aug 17.

Double-balloon catheter versus prostaglandin E2 for cervical ripening and labour induction: a systematic review and meta-analysis of randomised controlled trials

Y M Du  1 , L Y Zhu  1 , L N Cui  1 , B H Jin  1 , J L Ou  1
Affiliations
Meta-Analysis

Double-balloon catheter versus prostaglandin E2 for cervical ripening and labour induction: a systematic review and meta-analysis of randomised controlled trials

Y M Du et al. BJOG. 2017 May.

Abstract

Background: Induction of labour has become an increasingly common procedure. Ripening methods, including mechanical devices and pharmacological agents, improve the success rate of labour induction.

Objective: To compare the efficacy and safety of the double-balloon catheter with prostaglandin E2 agents used for labour induction.

Search strategy: We searched electronic sources from MEDLINE, Embase and Web of Science, the Cochrane Library Database of Systematic Reviews, and ClinicalTrials.gov website.

Selection criteria: Only randomised controlled trials comparing the PGE2 agents with the double-balloon catheter for cervical ripening and labour induction in women with unfavourable cervices were included in the analysis.

Data collection and analysis: The main outcomes included the vaginal delivery rate within 24 hours and risk of caesarean section. We calculated relative risks and mean differences using fixed- and random-effects models.

Main results: Nine studies (1866 patients) were included in this systematic review. Both the double-balloon catheter and PGE2 agents were comparable with regard to rate of caesarean section (RR 0.92; 95% CI 0.79, 1.07), vaginal delivery within 24 hours (RR 0.95; 95% CI 0.78, 1.16) and maternal adverse events, but the risk of excessive uterine activity (RR 10.02; 95% CI 3.99, 25.17) and need for neonatal intensive care unit admissions (RR 1.31; 95% CI 1.01, 1.69) were significantly increased in women who received PGE2 agents.

Conclusions: The double-balloon catheter demonstrated greater safety and cost-effectiveness than PGE2 agents for cervical ripening and labour induction. The efficacy profiles of both methods were similar.

Tweetable abstract: Double-balloon catheter versus prostaglandin E2 for cervical ripening and labour induction.

Keywords: Cervical ripening; double-balloon catheter; induction of labour; prostaglandin E2.

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