Balloon catheters versus vaginal prostaglandins for labour induction (CPI Collaborative): an individual participant data meta-analysis of randomised controlled trials

Jones, Miriam; Palmer, Kirsten; Pathirana, Maleesa M.; Cecatti, José Guilherme; Filho, Olímpio Barbosa Moraes; Marions, Lena; Edlund, Måns; Prager, Martina; Pennell, Craig E.; Dickinson, Jan E.; Sass, Nelson; Jozwiak, Marta; Eikelder, M. ten; Rengerink, Katrien Oude; Bloemenkamp, Kitty W. M.; Henry, Amanda; Løkkegaard, Ellen; Christensen, Ib Jarle; Szychowski, Jeff M.; Edwards, Rodney K.; Beckmann, Michael; Diguisto, Caroline; Gouge, Amélie Le; Perrotin, Franck; Symonds, Ian; O’Leary, Sean T.; Rolnik, Daniel L.; Mol, Ben W.; Li, Wentao

doi:10.1016/s0140-6736(22)01845-1

Cited by 19 publications

(18 citation statements)

References 31 publications

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“…Single‐balloon catheter is at least comparable to double‐balloon catheter and offers associated cost reductions to healthcare services. We recently demonstrated in another IPD‐MA that balloon catheters (single and double combined) and vaginal prostaglandins have comparable cesarean delivery rates and maternal safety profiles, but balloon catheters lead to fewer adverse perinatal events 27 . Therefore, balloon catheters should be used more widely in labor induction.…”

Section: Discussionmentioning

confidence: 99%

“…We recently demonstrated in another IPD‐MA that balloon catheters (single and double combined) and vaginal prostaglandins have comparable cesarean delivery rates and maternal safety profiles, but balloon catheters lead to fewer adverse perinatal events. 27 Therefore, balloon catheters should be used more widely in labor induction. Considering the findings of this study and the associated costs of interventions, single‐balloon catheter is a better option in the induction of labor, especially in low‐resource settings.…”

Section: Discussionmentioning

confidence: 99%

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Double‐vs single‐balloon catheter for induction of labor: Systematic review and individual participant data meta‐analysis

Peel,

Croll,

Kessler

et al. 2023

Acta Obstet Gynecol Scand

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IntroductionEvidence comparing double‐balloon versus single‐balloon catheter for induction of labor is divided. We aim to compare the efficacy and safety of double‐ versus single‐balloon catheters using individual participant data.Material and methodsA search of Ovid MEDLINE, Embase, Ovid Emcare, CINAHL Plus, Scopus, and clinicaltrials.gov was conducted for randomized controlled trials published from March 2019 until April 13, 2021. Earlier trials were identified from the Cochrane Review on Mechanical Methods for Induction of Labour. Randomized controlled trials that compared double‐balloon with single‐balloon catheters for induction of labor in singleton gestations were eligible. Participant‐level data were sought from trial investigators and an individual participant data meta‐analysis was performed. The primary outcomes were rates of vaginal birth achieved, a composite measure of adverse maternal outcomes and a composite measure of adverse perinatal outcomes. We used a two‐stage random‐effects model. Data were analyzed from the intention‐to‐treat perspective.ResultsOf the eight eligible randomized controlled trials, three shared individual‐level data with a total of 689 participants, 344 women in the double‐balloon catheter group and 345 women in the single‐balloon catheter group. The difference in the rate of vaginal birth between double‐balloon catheter and single‐balloon catheter was not statistically significant (relative risk [RR] 0.93, 95% confidence interval [CI] 0.86–1.00, p = 0.050; I2 0%; moderate‐certainty evidence). Both perinatal outcomes (RR 0.81, 95% CI 0.54–1.21, p = 0.691; I2 0%; moderate‐certainty evidence) and maternal composite outcomes (RR 0.65, 95% CI 0.15–2.87, p = 0.571; I2 55.46%; low‐certainty evidence) were not significantly different between the two groups.ConclusionsSingle‐balloon catheter is at least comparable to double‐balloon catheter in terms of vaginal birth rate and maternal and perinatal safety outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Double‐vs single‐balloon catheter for induction of labor: Systematic review and individual participant data meta‐analysis

Peel,

Croll,

Kessler

et al. 2023

Acta Obstet Gynecol Scand

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“…First of all, we cannot deny the small size of the cases in this study. In this study, we could not examine the incidence of uterine tachysystole associated with excessive uterine activity, which is a possible adverse event of prostaglandin E2 (PGE2) preparations [ 14 , 15 ]. However, there were not any cases of these complications associated with the small sample size in this study.…”

Section: Discussionmentioning

confidence: 99%

A Retrospective Comparative Study of the Effect of Controlled-Release Dinoprostone Vaginal Delivery System (Propess®) and Mechanical Methods for Cervical Ripening in Nulliparous Women in Late-Term Pregnancy

Shibata,

Yokoyama,

Suzuki

2023

Cureus

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Objective: The effects of the controlled-release dinoprostone vaginal delivery system (Propess ® ) and mechanical methods for cervical ripening in nulliparous women in late-term pregnancy were compared retrospectively. Methods: This retrospective comparative study included 46 nulliparous pregnant women (24 in the Propess ® group and 22 in the mechanical methods groups) with a low Bishop score (≤1) who needed labor induction at 41 weeks of gestation. The primary outcome was the success rate of cervical ripening (= Bishop score >6 or vaginal delivery) by the next day following the insertion of Propess ® only or mechanical cervical dilation only. In the cases in which cervical ripening was unsuccessful, other methods were performed, and the success rate of cervical ripening the day after was compared as the secondary outcome. Results: As the primary outcome, there was not a significant difference in the success rate of cervical ripening between the Propess ® and mechanical methods groups (21 vs. 22%, p = 0.88). As for the secondary outcomes, there was not a significant difference in the total success rate of cervical ripening between the two groups (75 (5+13/24) vs. 73 (5+11/22)%, p = 0.86)). Of the unsuccessful cervical ripening cases as secondary outcomes, the Bishop score of all was ≤2 on the second day of hospitalization. Conclusion: The combined use of Propess ® and mechanical methods was effective for cervical ripening in nulliparous women with a low Bishop score in late-term pregnancy, regardless of order.

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“…Finally, the use of oral misoprostol was associated with a lower risk of caesarean section. However, a meta-analysis recently published this November (22) administration, the dose could be repeated or oxytocin could be started (23).…”

Section: Discussionmentioning

confidence: 99%

How Do We Induce Labours in Spain? Results of the Inducespaña Survey

Fernandez

Mallen

Saiz

et al. 2022

Preprint

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Background Induction of labour (IDP) is the artificial initiation of labour with the goal of achieving a vaginal delivery. IDP is one of the most frequently performed obstetric procedures in the world. Recent data indicate a highly variable percentage of induction depending on the country. Methods A descriptive study was carried out on different aspects that are part of the ITP process through a survey prepared according to the Delphi method distributed among the 37 participating hospitals from June to October 2021. Results The mean induction rate was 30.6%. The average rate of caesarean sections was 21.4%. 75% of the centers had a rate higher than 20% and only in 1 center was it lower than 15%. In 11 centers they were not available to use misoprostol and in 4 centers they did not have oxytocin as PDI. Mechanical methods were available in 23 hospitals. In 16 centers they had a double Cook balloon; in 5 they used a Foley catheter and in 2 hospitals they used both devices. In 4 hospitals they used mechanical methods simultaneously with prostaglandins. In all but 5 centers, continuous monitoring was performed in low-risk pregnancies, at least for the first hour. In these 5 centers, windows of 20 minutes were carried out from the start of the induction.

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Balloon catheters versus vaginal prostaglandins for labour induction (CPI Collaborative): an individual participant data meta-analysis of randomised controlled trials

Cited by 19 publications

References 31 publications

Double‐vs single‐balloon catheter for induction of labor: Systematic review and individual participant data meta‐analysis

Double‐vs single‐balloon catheter for induction of labor: Systematic review and individual participant data meta‐analysis

A Retrospective Comparative Study of the Effect of Controlled-Release Dinoprostone Vaginal Delivery System (Propess®) and Mechanical Methods for Cervical Ripening in Nulliparous Women in Late-Term Pregnancy

How Do We Induce Labours in Spain? Results of the Inducespaña Survey

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