Cervical Ripening Using Foley Balloon with or without Oxytocin: A Systematic Review and Meta-Analysis

Gallagher, Lauren; Gardner, Benjamin; Rahman, Mahbubur; Schoen, Corina N.; Connolly, Katherine A.; Hankins, Gary D.V.; Saade, George R.; Saad, Antonio F.

doi:10.1055/s-0038-1668577

Cited by 23 publications

(17 citation statements)

References 13 publications

(72 reference statements)

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“…They observed lower TID, and a higher rate of delivery <24 h in the group with combined catheter and oxytocin. A recent meta-analysis has also demonstrated that simultaneous use of oxytocin with a Foley catheter could shorten induction to delivery time and increase deliveries within 12 to 24 h [ 20 ]. The adjunction of oxytocin is likely to favor a synergistic action.…”

Section: Discussionmentioning

confidence: 99%

“…As concomitant administration of prostaglandin and oxytocin is strictly forbidden to prevent the risk of tachysystolia or uterine hyperstimulation [ 21 ], oxytocin may be administrated earlier when used in combination with mechanical devices, positively impacting the period of time before birth. Finally, the combination of catheter plus oxytocin has not been shown to impact rates of caesarean section, postpartum hemorrhage, or neonatal complications [ 19 , 20 , 22 ].…”

Section: Discussionmentioning

confidence: 99%

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Double Balloon Catheter (Plus Oxytocin) versus Dinoprostone Vaginal Insert for Term Rupture of Membranes: A Randomized Controlled Trial (RUBAPRO)

Devillard

Petillon

Rouzaire

et al. 2022

JCM

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Background: The aim of this study is to demonstrate that a double balloon catheter combined with oxytocin decreases time between induction of labor and delivery (TID) as compared to a vaginal dinoprostone insert in cases of premature rupture of membranes at term. Methods: This is a prospective, randomized, controlled trial including patient undergoing labor induction for PROM at term with an unfavorable cervix in Clermont-Ferrand university hospital. We compared the double balloon catheter over a period of 12 h with adjunction of oxytocin 6 h after catheter insertion versus dinoprostone vaginal insert. After device ablation, cervical ripening continued only with oxytocin. The main outcome was TID. Secondary outcomes concerned delivery mode, as well as maternal and fetal outcome, and were adjusted for parity. Results: 40 patients per group were randomized. Each group had similar baseline characteristics. The study failed to demonstrate reduced TID (16.2 versus 20.2 h, ES = 0.16 (−0.27 to 0.60), p = 0.12) in the catheter group versus dinoprostone except in nulliparous women (17.0 versus 26.5 h, ES = 0.62 (0.10 to 1.14), p = 0.006). The rate of vaginal delivery <24 h significantly increased with combined induction (88.5% versus 66.6%, p = 0.03). No statistical difference was observed concerning caesarean rate (12.5% versus 17.5%, p > 0.05), chorioamnionitis (0% versus 2.5%, p = 1), postpartum endometritis, or maternal or neonatal outcomes. Procedure-related pain and tolerance to devices were found to be similar for the two methods. Interpretation: The double balloon catheter combined with oxytocin is an alternative for cervical ripening in case of PROM at term, and may reduce TID in nulliparous women.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Double Balloon Catheter (Plus Oxytocin) versus Dinoprostone Vaginal Insert for Term Rupture of Membranes: A Randomized Controlled Trial (RUBAPRO)

Devillard

Petillon

Rouzaire

et al. 2022

JCM

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“…Among the mechanical methods, the most popular is the Foley catheter 89, 90 , either alone 91 or in association with oxytocin 92– 96 , or misoprostol 97, 98 , and with different balloon volumes 99, 100 . The combination of mechanical and pharmacological methods used simultaneously does not show clear benefits in terms of mode of delivery: the use of the Foley catheter with oxytocin increases the rate of delivery within 24 hours in nulliparas 95, 96 , while the association of Foley and misoprostol 101 reduces the intervention to delivery time interval and the number of uterine hyperstimulations, in both cases without influencing cesarean delivery rates.…”

Section: Methods Of Inductionmentioning

confidence: 99%

Recent advances in the induction of labor

Marconi

2019

F1000Res

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The rate of labor induction is steadily increasing and, in industrialized countries, approximately one out of four pregnant women has their labor induced. Induction of labor should be considered when the benefits of prompt vaginal delivery outweigh the maternal and/or fetal risks of waiting for the spontaneous onset of labor. However, this procedure is not free of risks, which include an increase in operative vaginal or caesarean delivery and excessive uterine activity with risk of fetal heart rate abnormalities. A search for “Induction of Labor” retrieves more than 18,000 citations from 1844 to the present day. The aim of this review is to summarize the controversies concerning the indications, the methods, and the tools for evaluating the success of the procedure, with an emphasis on the scientific evidence behind each.

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“…9e12 Similarly, a systematic review and meta-analysis found that dual agent ripening with Foley catheter and oxytocin decreased time to delivery without increase in maternal and neonatal adverse outcomes compared with Foley alone. 13 Overall, these studies provided high-quality evidence to support the use of dual agent cervical ripening methods for labor induction.…”

mentioning

confidence: 89%

Combination of Foley and prostaglandins versus Foley and oxytocin for cervical ripening: a network meta-analysis

Orr¹,

Reisinger‐Kindle

Roy

et al. 2020

American Journal of Obstetrics and Gynecology

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BACKGROUND: Trial and meta-analysis data revealed a reduction in time to delivery for Foley and prostaglandins or Foley and oxytocin vs Foley alone. However, there are limited data for the comparison of the 2 combination methods against each other. OBJECTIVE: This study aimed to determine whether Foley and prostaglandins or Foley and oxytocin decrease the time to vaginal delivery using a network meta-analysis. STUDY DESIGN: A network meta-analysis (PROSPERO CRD42018081948) was performed comparing Foley and prostaglandins (prostaglandin E1 or prostaglandin E2) vs Foley and oxytocin for cervical ripening. Foley alone and prostaglandins alone were used as nodes for indirect comparison. Database searches were performed from inception to March 2020 with data abstracted from published manuscripts. Eligibility criteria included randomized trials comparing Foley and oxytocin with Foley and prostaglandins (misoprostol or dinoprostone). Trials that compared Foley catheter or prostaglandins with a combination of Foley and prostaglandins or Foley and concurrent oxytocin were also included. Nulliparous and multiparous women were analyzed together. Foley catheters of any catheter material or size and >24 weeks' gestational age with a live fetus were included. Quasi-randomized, cohorts, and other combination methods for cervical ripening were not included. Prostaglandin E1 and prostaglandin E2 combined methods were analyzed separately in a planned subanalysis. The primary outcome was the mean time from induction to vaginal delivery in hours. Secondary outcomes included time from induction to delivery, delivery within 24 hours, cesarean delivery, chorioamnionitis, endometritis, epidural use, tachysystole, postpartum hemorrhage, meconium, neonatal intensive care unit admission, and 5minute appearance, pulse, grimace, activity, and respiration score of <7. Data were analyzed as a network meta-analysis using multivariate meta-regression.RESULTS: A total of 30 randomized controlled trials with a total of 6465 women were considered eligible for inclusion in this network metaanalysis. When compared with Foley alone, the use of Foley-oxytocin reduced the time to vaginal delivery by 4.2 hours (mean duration, e4.2 hours; 95% confidence interval, e6.5 to e1.9). Foley-prostaglandins reduced the time to vaginal delivery compared with Foley but did not meet statistical significance (mean duration, e2.9 hours; 95% confidence interval, e5.7 to 0.0; P¼.05). When compared head-to-head, there was no difference in the time to vaginal delivery between Foley-prostaglandins and Foley-oxytocin (mean duration, 1.3 hours; 95% confidence interval, e2.0 to 4.7). There was no difference in the rate of cesarean delivery, chorioamnionitis, epidural, tachysystole, postpartum hemorrhage, meconium, neonatal intensive care unit admissions, or 5-minute appearance, pulse, grimace, activity, and respiration score of <7 for Foley-prostaglandins vs Foley-oxytocin, although the rate of endometritis was high for Foley-prostaglandins. In the subanalysis by prostaglandin...

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Cervical Ripening Using Foley Balloon with or without Oxytocin: A Systematic Review and Meta-Analysis

Cited by 23 publications

References 13 publications

Double Balloon Catheter (Plus Oxytocin) versus Dinoprostone Vaginal Insert for Term Rupture of Membranes: A Randomized Controlled Trial (RUBAPRO)

Double Balloon Catheter (Plus Oxytocin) versus Dinoprostone Vaginal Insert for Term Rupture of Membranes: A Randomized Controlled Trial (RUBAPRO)

Recent advances in the induction of labor

Combination of Foley and prostaglandins versus Foley and oxytocin for cervical ripening: a network meta-analysis

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