Misoprostol With Foley Bulb Compared With Misoprostol Alone for Cervical Ripening

Al-Ibraheemi, Zainab; Brustman, Lois; Bimson, Brianne; Porat, Natalie; Rosenn, Barak

doi:10.1097/aog.0000000000002403

Cited by 29 publications

(28 citation statements)

References 11 publications

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“…Of the 224 records found through database searches, 30 RCTs were identified and assessed for eligibility. Seventeen of the RCTs did not meet the inclusion criteria for the correct intervention and full text could not be obtained for 3 of the studies, leaving a total of 10 RCTs to be included in the meta-analysis [33,[48][49][50][51][52][53][54]56,57] (Figure 1).…”

Section: Study Selection Quality Assessment and Study Characteristicsmentioning

confidence: 99%

“…2018 [48] to inner thigh doses doses Heterogeneity: Tau 2 = 3.500; ꭓ 2 = 104.455, df = 6 (p = 0.000); I 2 = 94.256%. Test for overall effect (random): Z = −3.264, (p = 0.001).…”

Section: Time To Deliverymentioning

confidence: 99%

“…Six of the studies had analysis for meconium stained amniotic fluid/liquor. Among them, only Al-Ibraheemi et al stratified meconium stain into light, moderate, and thick [48]. For analysis, all three of the categories were included and pooled into the meta-analysis.…”

Section: Meconium Stainmentioning

confidence: 99%

“…Many studies have compared the two methods, intravaginal misoprostol and intracervical Foley catheter, individually or when used concurrently [48][49][50][51][52][53][54][55][56][57][58][59]. It has been proposed that the two different mechanisms may have synergistic effects, as found by Al-Ibraheemi Z et al and numerous other authors [48][49][50]52,53]. However, there have been other studies that showed a lack of such synergistic effect [54,55], while another study showed no significant benefits to the induction-delivery time but did reduce complications such as uterine hyper stimulation [51].…”

Section: Introductionmentioning

confidence: 99%

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Intracervical Foley Catheter Plus Intravaginal Misoprostol vs Intravaginal Misoprostol Alone for Cervical Ripening: A Meta-Analysis

Lee

Huang

Chen

et al. 2020

IJERPH

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Currently, there is no meta-analysis comparing intravaginal misoprostol plus intracervical Foley catheter versus intravaginal misoprostol alone for term pregnancy without identifying risk factors. Therefore, the purpose of this study is to conduct a systematic review and meta-analysis of randomized control trials (RCTs) comparing concurrent intravaginal misoprostol and intracervical Foley catheter versus intravaginal misoprostol alone for cervical ripening. We systematically searched Embase, Pubmed, and Cochrane Collaboration databases for randomized controlled trials (RCTs) comparing intracervical Foley catheter plus intravaginal misoprostol and intravaginal misoprostol alone using the search terms “Foley”, “misoprostol”, “cervical ripening”, and “induction” up to 29 January 2019. Data were extracted and analyzed by two independent reviewers including study characteristics, induction time, cesarean section (C/S), clinical suspicion of chorioamnionitis, uterine tachysystole, meconium stain, and neonatal intensive care unit (NICU) admissions. Data was pooled using random effects modeling and calculated with risk ratio (RR) and 95% confidence interval (CI). Pooled analysis from eight studies, including 1110 women, showed that labor induction using a combination of intracervical Foley catheter and intravaginal misoprostol decreased induction time by 2.71 h (95% CI −4.33 to −1.08, p = 0.001), as well as the risk of uterine tachysystole and meconium staining (RR 0.54, 95% CI 0.30–0.99 and RR 0.48, 95% CI 0.32–0.73, respectively) significantly compared to those using intravaginal misoprostol alone. However, there was no difference in C/S rate (RR 0.93, 95% CI 0.78–1.11) or clinical suspicion of chorioamnionitis rate (RR 1.22, CI 0.58–2.57) between the two groups. Labor induction with a combination of intracervical Foley catheter and intravaginal misoprostol may be a better choice based on advantages in shortening induction time and reducing the risk of uterine tachysystole and meconium staining compared to intravaginal misoprostol alone.

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Section: Study Selection Quality Assessment and Study Characteristicsmentioning

confidence: 99%

“…2018 [48] to inner thigh doses doses Heterogeneity: Tau 2 = 3.500; ꭓ 2 = 104.455, df = 6 (p = 0.000); I 2 = 94.256%. Test for overall effect (random): Z = −3.264, (p = 0.001).…”

Section: Time To Deliverymentioning

confidence: 99%

Section: Meconium Stainmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Intracervical Foley Catheter Plus Intravaginal Misoprostol vs Intravaginal Misoprostol Alone for Cervical Ripening: A Meta-Analysis

Lee

Huang

Chen

et al. 2020

IJERPH

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“…16 Though results are conflicting as regards the efficacy of mechanical versus pharmaceutical methods of induction, it is agreed that combination of both results yielded the best outcome. [27][28][29]…”

Section: Pharmaceutical Versus Mechanical Induction Of Labormentioning

confidence: 99%

Pharmaceutical versus mechanical induction of labor

Alsaif

Helmy²,

Almuallem

et al. 2018

Int J Reprod Contracept Obstet Gynecol

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Labor induction is one of the most common obstetric interventions carried out in obstetric institutions. More than one fifth of labors needs induction. To date, many methods are available for labor induction with the pharmaceutical and mechanical methods being the commonest. The most common pharmaceutical agents used are prostaglandins, oxytocin, synthetic progesterone antagonists, and nitric oxide. Mechanical induction is carried out through using balloon catheters, hygroscopic dilators, artificial membrane rupture, or membrane stripping. Though pharmaceutical methods had largely replaced mechanical induction of labor, no consensus guidelines recommend their use. Studies from literature are still conflicting. However, it is generally agreed that the use of a combined approach with both pharmaceutical and mechanical methods of induction yields the best outcome. This article will review the different methods for labor induction, their effectiveness, and adverse events.

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Mechanical methods for induction of labour

Vaan

Eikelder

Jozwiak

et al. 2019

Cochrane Database of Systematic Reviews

101

117

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BackgroundMechanical methods were the first methods developed to ripen the cervix and induce labour. During recent decades they have been substituted by pharmacological methods. Potential advantages of mechanical methods, compared with pharmacological methods may include reduction in side effects that could improve neonatal outcomes. This is an update of a review first published in 2001, last updated in 2012.ObjectivesTo determine the effectiveness and safety of mechanical methods for third trimester (> 24 weeks' gestation) induction of labour in comparison with prostaglandin E2 (PGE2) (vaginal and intracervical), low‐dose misoprostol (oral and vaginal), amniotomy or oxytocin.Search methodsFor this update, we searched Cochrane Pregnancy and Childbirth’s Trials Register, , the WHO International Clinical Trials Registry Platform (), and reference lists of retrieved studies (9 January 2018). We updated the search in March 2019 and added the search results to the awaiting classification section of the review.Selection criteriaClinical trials comparing mechanical methods used for third trimester cervical ripening or labour induction with pharmacological methods.Mechanical methods include: (1) the introduction of a catheter through the cervix into the extra‐amniotic space with balloon insufflation; (2) introduction of laminaria tents, or their synthetic equivalent (Dilapan), into the cervical canal; (3) use of a catheter to inject fluid into the extra‐amniotic space (EASI).This review includes the following comparisons: (1) specific mechanical methods (balloon catheter, laminaria tents or EASI) compared with prostaglandins (different types, different routes) or with oxytocin; (2) single balloon compared to a double balloon; (3) addition of prostaglandins or oxytocin to mechanical methods compared with prostaglandins or oxytocin alone.Data collection and analysisTwo review authors independently assessed trials for inclusion and assessed risk of bias. Two review authors independently extracted data and assessed the quality of the evidence using the GRADE approach.Main resultsThis review update includes a total of 113 trials (22,373 women) contributing data to 21 comparisons. Risk of bias of trials varied. Overall, the evidence was graded from very‐low to moderate quality. All evidence was downgraded for lack of blinding and, for many comparisons, the effect estimates were too imprecise to make a valid judgement.Balloon versus vaginal PGE2: there may be little or no difference in vaginal deliveries not achieved within 24 hours (average risk ratio (RR) 1.01, 95% confidence interval (CI) 0.82 to 1.26; 7 studies; 1685 women; I² = 79%; low‐quality evidence) and there probably is little or no difference in caesarean sections (RR 1.00, 95% CI 0.92 to 1.09; 28 studies; 6619 women; moderate‐quality evidence) between induction of labour with a balloon catheter and vaginal PGE2. A balloon catheter probably reduces the risk of uterine hyperstimulation with fetal heart rate (FHR) changes (RR 0.35, 95% CI 0.18 to 0.67; 6 studies; 1966 ...

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Misoprostol With Foley Bulb Compared With Misoprostol Alone for Cervical Ripening

Abstract: ClinicalTrials.gov, NCT02566005.

Cited by 29 publications

References 11 publications

Intracervical Foley Catheter Plus Intravaginal Misoprostol vs Intravaginal Misoprostol Alone for Cervical Ripening: A Meta-Analysis

Intracervical Foley Catheter Plus Intravaginal Misoprostol vs Intravaginal Misoprostol Alone for Cervical Ripening: A Meta-Analysis

Pharmaceutical versus mechanical induction of labor

Mechanical methods for induction of labour

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