Am J Perinatol 2019; 36(08): 790-797
DOI: 10.1055/s-0038-1675206
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Single versus Double-Balloon Transcervical Catheter for Labor Induction: A Systematic Review and Meta-Analysis

Samantha X. de los Reyes
1   Division of Maternal Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
,
Jeanne S. Sheffield
1   Division of Maternal Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
,
Ahizechukwu C. Eke
1   Division of Maternal Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
› Author Affiliations

Funding None.
Further Information

Publication History

22 November 2017

29 August 2018

Publication Date:
31 October 2018 (online)

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Abstract

Objective To evaluate for difference in outcomes between single- and double-balloon catheters for labor induction.

Study Design We searched CINAHL, Embase, Cochrane Register, MEDLINE, ISI Web of Sciences, LILACs, and Google Scholar and retrieved studies through May 2017. Selection criteria included randomized controlled trials comparing single- versus double-balloon catheters. The primary outcome was time from catheter insertion to delivery. Heterogeneity of the results among studies was tested with the quantity I2 . For I2 values ≥50%, a random effects model was used to pool data across studies. Summary measures were reported as adjusted odds ratios (aORs) or as a mean difference (MD) with 95% confidence interval (CI).

Results Four trials including a total of 682 patients were included: 340 patients were randomized to induction with a single-balloon catheter and 342 to induction with a double-balloon catheter. There was no significant difference between groups with respect to time to delivery (18.8 vs. 19.6 hours; MD: 0.40; 95% CI: –1.56 to 0.76), vaginal delivery rate (65.3 vs. 62.3%; aOR: 1.04; 95% CI: 0.56–1.92), cesarean delivery rate (25.6 vs. 27.5%; aOR: 0.98; 95% CI: 0.55–1.73), or epidural use (58.4 vs. 62%; aOR: 0.81; 95% CI: 0.56–1.18).

Conclusion Double-balloon catheters have no apparent advantage over single-balloon catheters for labor induction.