Comparison of single- and double-balloon catheters for labor induction: a systematic review and meta-analysis of randomized controlled trials

Salim, Raed; Schwartz, Naama; Zafran, Noah; Zuarez-Easton, Sivan; Garmi, Gali; Romano, Shabtai

doi:10.1038/s41372-017-0005-7

Cited by 17 publications

(18 citation statements)

References 26 publications

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“…Double balloon catheters not associated with any significant difference in the rate of CD or mean time to delivery. Double balloon catheters are associated with reduced maternal satisfaction, increased maternal pain, increased cost [25,36,37]. Avoiding routine reduction, discontinuation, or withholding of epidural analgesia to prevent labor disorders, operative vaginal delivery, or cesarean delivery.…”

Section: Early Pushing In Second Stagementioning

confidence: 99%

Novel Evidence-Based Labor Induction Algorithm Associated with Increased Vaginal Delivery within 24 Hours

et al. 2022

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Objective: To assess whether concordance with our proposed labor induction algorithm is associated with an increased rate of vaginal delivery within 24 hours. Study Design: We conducted a retrospective review of 287 IOLs at a single urban, tertiary, academic medical center which took place before we created an evidence-based induction of labor (IOL) algorithm. We then compared the IOL course to the algorithm to assess for concordance and outcomes. Patients age 18 or over with a singleton, cephalic pregnancy of 36 6/7 to 42 0/7 weeks’ gestation were included. Patients were excluded with a Bishop score >6, contraindication to misoprostol or cervical Foley catheter, major fetal anomalies or intrauterine fetal death. Patients with 100% concordance were compared to <100% concordant patients, and patients with 80% concordance were compared to <80% concordant patients. Adjusted hazard ratios (AHRs) were calculated for rate of vaginal delivery within 24 hours, our primary outcome. Competing risks analysis was conducted for concordant vs. non-concordant groups, using vaginal delivery as the outcome of interest, with cesarean delivery as a competing event. Results: Patients with 100% concordance were more likely to have a vaginal delivery within 24 hours, n = 66/77 or 85.7% vs. n = 120/210 or 57.1% (p<0.0001), with an AHR of 2.72 (1.98, 3.75, p<0.0001) after adjusting for delivery indication and scheduled status. Patients with 100% concordance also had shorter time from first intervention to delivery (11.9 vs. 19.4 hours). Patients with 80% concordance had a lower rate of cesarean delivery (11/96, 11.5%) compared to those with <80% concordance (43/191 = 22.5%) (p=0.0238). There were no differences in neonatal outcomes assessed. Conclusion: Our IOL algorithm may offer an opportunity to standardize care, improve the rate of vaginal delivery within 24 hours, shorten time to delivery, and reduce the cesarean delivery rate for patients undergoing IOL.

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Section: Early Pushing In Second Stagementioning

confidence: 99%

Novel Evidence-Based Labor Induction Algorithm Associated with Increased Vaginal Delivery within 24 Hours

et al. 2022

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“…Although effective, pharmacological methods of labor induction have been associated with potential risks, such as uterine tachysystole with or without fetal heart rate changes, uterine rupture, fetal distress, and maternal and perinatal morbidity and mortality. 2 19 20 21 22 The incidence of these adverse events is dependent on the agent used for induction, dose, and other factors. The appropriate method of induction, whether pharmacological and/or mechanical, may vary depending on maternal and neonatal factors, patient demographics, and other variables that can complicate clinical trial design and present a barrier to evidence-based recommendations.…”

mentioning

confidence: 99%

Challenges and Limitations of Clinical Trials on Labor Induction: A Review of the Literature

Viteri

Sibai

2018

AJP Rep

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Induction of labor is a common obstetric procedure performed in nearly a quarter of all deliveries in the United States. Pharmacological (prostaglandins, oxytocin) and/or mechanical methods (balloon catheters) are commonly used for labor induction; however, there is ongoing debate as to which method is the safest and most effective. This narrative review discusses key limitations of published trials on labor induction, including the lack of well-designed randomized controlled trials directly comparing specific methods of induction, heterogeneous trial populations, and wide variation in the protocols used and outcomes reported. Furthermore, the majority of published trials were underpowered to detect significant differences in the most clinically relevant efficacy and safety outcomes (e.g., cesarean delivery, neonatal mortality). By identifying the limitations of labor induction trials, we hope to highlight the importance of quality published data to better inform guidelines and drive evidence-based treatment decisions.

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“…However, not all of these strategies have been proven to shorten this process. Although a double balloon or applying traction may shorten the period from start of induction to expulsion of the balloon, these approaches do not increase the number of vaginal deliveries within 24 h and have the disadvantage of causing more pain during the induction process [15][16][17][18] .…”

Section: Discussionmentioning

confidence: 99%

Induction of labor with Foley catheter and risk of subsequent preterm birth: follow‐up study of two randomized controlled trials (PROBAAT‐1 and ‐2)

Vaan

Blel

Bloemenkamp

et al. 2021

Ultrasound in Obstet & Gyne

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What are the novel findings of this work? In women scheduled for induction of labor and an unripe cervix, induction with a Foley catheter probably does not increase the risk of preterm birth in a subsequent pregnancy. What are the clinical implications of this work? Clinicians should not be hesitant on using a Foley catheter for induction of labor because of a non-existent, hypothetical increased risk of preterm birth in a subsequent pregnancy, as it has a more optimal neonatal safety profile compared to pharmacological methods.

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Comparison of single- and double-balloon catheters for labor induction: a systematic review and meta-analysis of randomized controlled trials

Abstract: Time from catheter insertion to delivery and delivery mode were comparable between the two types of catheter.

Cited by 17 publications

References 26 publications

Novel Evidence-Based Labor Induction Algorithm Associated with Increased Vaginal Delivery within 24 Hours

Novel Evidence-Based Labor Induction Algorithm Associated with Increased Vaginal Delivery within 24 Hours

Challenges and Limitations of Clinical Trials on Labor Induction: A Review of the Literature

Induction of labor with Foley catheter and risk of subsequent preterm birth: follow‐up study of two randomized controlled trials (PROBAAT‐1 and ‐2)

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