Double- versus single-balloon catheters for labour induction and cervical ripening: a meta-analysis

Xiyao Liu, Yu Wang, Fan Zhang, Xiaoni Zhong, Rong Ou, Xin Luo, Hongbo Qi, Xiyao Liu, Yu Wang, Fan Zhang, Xiaoni Zhong, Rong Ou, Xin Luo, Hongbo Qi

Abstract

Background: The induction of labour is an increasingly common procedure in the obstetrics field. Various methods have been used to induce labour, among which balloon catheters play an important role. Whether the specifically designed double-balloon catheter is better than the single-balloon device in terms of efficacy, efficiency, safety and patient satisfaction remains controversial. Identifying even small differences between these two devices could be useful to guide clinical practices, to further explore their mechanisms, and to promote a better understanding of the optimal methods for inducing labour.

Methods: Using the population, intervention, comparison, outcomes and study designs (PICOS) principle, we searched the PubMed, EMBASE, OVID, SCI, CENTRAL, ClinicalTrial.gov , and CDSR databases to identify relevant randomised controlled trials (RCTs) from inception through February 14, 2018. The primary outcome was the caesarean delivery rate, and the secondary outcomes focused on efficacy, efficiency, safety, and patient satisfaction. The relative risks or mean differences, including their 95% confidence intervals, were calculated using fixed-effects or random-effects models. All statistical analyses were completed with RevMan version 5.3.

Results: From a total of 1326 articles, 7 RCTs involving 1159 women were included. There were no significant differences in primary outcomes (RR, 0.88 [0.65, 1.2]; p-value, 0.43) or secondary outcomes identified between single- and double-balloon catheters. However, heterogeneity existed for some aspects.

Conclusion: Both kinds of balloon catheter have similar levels of efficacy, efficiency, safety and patient satisfaction; however, the single-balloon method is considered to be more cost-effective.

Keywords: Balloon catheter; Cervical ripening; Labour induction; Meta-analysis.

Conflict of interest statement

We declare that none of the authors have any financial relationships or personal relationships with people, pharmaceutical companies or other commercial entities that have an interest in the subject matter or materials discussed in the article.

Figures

Fig. 1
Fig. 1
Literature search and screening process
Fig. 2
Fig. 2
a Risk of bias graph. b. Risk of bias summary
Fig. 3
Fig. 3
a Forest plot of cesarean delivery. b. Funnel plot of cesarean delivery

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Source: PubMed

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