Concurrent administration of oxytocin with Foley catheter versus Misoprostol for induction of labor: A systematic review and meta-analysis

Abstract

Background: Around one- third of pregnancies require labor induction due to several reasons such as post-term pregnancy, stillbirth, and medical complications. This systematic review aimed to evaluate the effect of concurrent administration of Foley catheter plus oxytocin versus Misoprostol on labor induction.Methods: The search was conducted in April 2019 and updated in September 2020. The following databases were searched: PubMed, SCOPUS, Cochrane Central Register of controlled trials, and Web of Science. Primary outcome included cesarean section rate. Secondary outcomes were the mean duration of induction to delivery and delivery in less than 12 hours from induction. Data were analyzed using RevMan. For binary outcomes, the odds ratio with 95% confidence intervals (CI), and for continuous outcomes, the mean difference (MD) with 95% CI was measured.Results: Four studies were included in this review. The cesarean section rate in Foley plus oxytocin was not significantly different from vaginal Misoprostol (OR = 0.95; 95 % CI: 0.70, 1.30) and (OR = 0.92; 95 % CI: 0.66, 1.29) respectively. Foley plus oxytocin decreased the mean duration of induction to delivery compared to vaginal Misoprostol in nuligravida (MD = -6.74; 95% CI -9.20, -4.28), and increased delivery in less than 12 hours from induction (OR = 2.08; 95 % CI: 1.43, 3.02).Conclusion: Although the rate of cesarean and vaginal delivery was not different in two groups of Foley catheter plus oxytocin and vaginal Misoprostol, the mean time of induction to delivery reduced and delivery in less than 12 hours from induction increased in the Foley plus oxytocin.