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Grand Rounds

Meta-analysis: Simultaneous Foley Catheter and Oxytocin for Successful Induction of Labor

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BACKGROUND AND PURPOSE: 

  • Liu et al. (Journal of Maternal-Fetal & Neonatal Medicine, 2018) assessed whether the use of simultaneous Foley catheter and oxytocin impacted induction outcome 

METHODS: 

  • Meta-analysis of RCTs  
  • Studies included that compared Foley catheter with simultaneous oxytocin use vs Foley catheter followed by oxytocin (i.e. control group)  
  • Participants were separated out in to 3 groups  
    • Nulliparas and multiparas 
    • Only nulliparas 
    • Only multiparas 
  • Outcomes 
    • Delivery in 24 h | Vaginal delivery in 24 h | Cesarean delivery | Time to delivery | Apgar score at 5 min <7 | Chorioamnionitis | PPH | Uterine hyperstimulation | NICU admission 

RESULTS: 

  • 6 RCTs were included, totaling 1133 participants 
  • Only among nulliparous women did there appear to be benefit with simultaneous Foley and oxytocin  
    • Relative risk of delivery within 24 hours 1.32 (95% CI: 1.12-1.55) 
  • There was no significant difference between groups for 
    • Vaginal delivery in 24 hours 
    • Cesarean delivery 
    • Time to delivery 
    • Apgar score at 5 min <7 
  • Foley catheter with simultaneous oxytocin did not increase the risk of side effects 

CONCLUSION: 

  • Simultaneous oxytocin and Foley catheter at the initiation of labor induction increased rates of delivery within 24 hours among nulliparas 

Learn More – Primary Sources: 

Foley catheter with simultaneous oxytocin on labor induction: a meta-analysis of randomized controlled trials.

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Related ObG Topics:

Does Adding a Foley to Oxytocin Following PROM Improve Time to Delivery?
The FIAT-M study: Simultaneous or Sequential Foley and Oxytocin for Induction in Multiparous Women
Foley Bulb Catheter for Induction Following PROM in Nulliparas
Practical info on evidence based medicine for your women's healthcare practice
Labor Induction and an Unripe Cervix: Does it Result in More C-sections?

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