Foley catheter balloon vs locally applied prostaglandins for cervical ripening and labor induction: A systematic review and metaanalysis

Zvi Vaknin, Yaffa Kurzweil, Dan Sherman

Research output: Contribution to journalReview articlepeer-review

Abstract

We performed a metaanalysis of publications comparing the efficacy and safety of cervical ripening and labor induction by Foley catheter balloon (FCB) vs locally applied prostaglandins (LAPG) in the third trimester of pregnancy. Twenty-seven randomized controlled trials (1966-2008; 3532 participants) were selected from MEDLINE, EMBASE, and CENTRAL searches. There was no significant difference between FCB and LAPG in cesarean delivery rates. LAPG had a significantly increased risk of excessive uterine activity (P = .001). FCB had a significantly higher risk of oxytocin induction/augmentation during labor (P = .0002). Cervical prostaglandin-E2 was less effective (P = .04), and vaginal prostaglandin-E1 bore a significantly higher risk of excessive uterine activity (P < .0001) and meconium staining (P = .04). We concluded that FCB and LAPG result in similar cesarean delivery rates, that FCB bears a higher risk of oxytocin use for labor induction and/or augmentation, and that LAPG carries a higher risk of contraction abnormalities.

Original languageEnglish
Pages (from-to)418-429
Number of pages12
JournalAmerican Journal of Obstetrics and Gynecology
Volume203
Issue number5
DOIs
StatePublished - Nov 2010

Keywords

  • cervical ripening
  • Foley catheter balloon
  • labor induction
  • prostaglandins

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