This study by Du et al. (BJOG, 2017) sought to compare the safety and efficacy of double-balloon catheter and prostaglandin E2 (PGE2) agents for inducing labor.
Systematic Review and Meta-Analysis of Randomized Controlled Trials
Nine studies including 1,866 patients were included in this survey. The primary outcome measure was vaginal delivery rate within 24 hours and C-section risk. There was no statistical difference found between double-balloon catheter and PGE2 agents (relative risk 0.92; 95% CI 0.79-1.07) or vaginal delivery within 24 hours (relative risk 0.95; 95% CI 0.78-1.16). Nor did the investigators find any differences maternal adverse events. However, excessive uterine activity was strongly associated with PGE2 agents (relative risk 10.02; 95% CI 3.99-25.17. In addition, NICU admission rates were also higher in the PGE2 group (relative risk 1.31; 95% CI 1.01-1.69). The authors conclude that while both mechanical and pharmacologic cervical ripening agents are effective, the double-balloon catheter is safer and more cost-effective.
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