Wenhang Chen1, Jing Xue2, Laura Gaudet3, Mark Walker4, Shi Wu Wen5. 1. Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University, Changsha, China; OMNI Research Group, Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, Canada; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada. 2. OMNI Research Group, Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, Canada; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada; Department of Epidemiology, School of Public Health, Central South University, Changsha, China. 3. OMNI Research Group, Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, Canada; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada. 4. OMNI Research Group, Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, Canada; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada; Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada. 5. OMNI Research Group, Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, Canada; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada; Department of Epidemiology, School of Public Health, Central South University, Changsha, China; Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada. Electronic address: swwen@ohri.ca.
Abstract
BACKGROUND: The effectiveness of Foley catheter plus misoprostol for cervical ripening has not been convincingly shown in trials. OBJECTIVES: To summarize the evidence comparing Foley catheter plus misoprostol versus misoprostol alone for cervical ripening. SEARCH STRATEGY: Embase, Medline, and Cochrane Collaboration databases were searched with the terms "Foley catheter," "misoprostol," "cervical ripening," and "labor induction." SELECTION CRITERIA: Randomized controlled trials comparing the methods of cervical ripening for delivery of a viable fetus were included. DATA COLLECTION AND ANALYSIS: Study characteristics, quality, and outcomes were recorded. Random-effects models were used to combine data. MAIN RESULTS: Eight trials were included, with 1153 patients overall. In a pooled analysis of seven high-quality studies, the combination group had a decreased time to delivery (mean difference -2.36 hours, 95% confidence interval [CI] -4.07 to -0.66; P=0.007). Risk of chorioamnionitis was significantly increased in the combination group (risk ratio [RR] 2.07, 95% CI 1.04-4.13; P=0.04), and that of tachysystole with fetal heart rate changes was decreased (RR 0.58, 95% CI 0.38-0.91; P=0.02). Frequency of cesarean did not differ (P=0.77). CONCLUSIONS: The combined use of Foley catheter and misoprostol results in a reduced time to delivery, a reduced frequency tachysystole with fetal heart rate changes, and an increased incidence of chorioamnionitis.
BACKGROUND: The effectiveness of Foley catheter plus misoprostol for cervical ripening has not been convincingly shown in trials. OBJECTIVES: To summarize the evidence comparing Foley catheter plus misoprostol versus misoprostol alone for cervical ripening. SEARCH STRATEGY: Embase, Medline, and Cochrane Collaboration databases were searched with the terms "Foley catheter," "misoprostol," "cervical ripening," and "labor induction." SELECTION CRITERIA: Randomized controlled trials comparing the methods of cervical ripening for delivery of a viable fetus were included. DATA COLLECTION AND ANALYSIS: Study characteristics, quality, and outcomes were recorded. Random-effects models were used to combine data. MAIN RESULTS: Eight trials were included, with 1153 patients overall. In a pooled analysis of seven high-quality studies, the combination group had a decreased time to delivery (mean difference -2.36 hours, 95% confidence interval [CI] -4.07 to -0.66; P=0.007). Risk of chorioamnionitis was significantly increased in the combination group (risk ratio [RR] 2.07, 95% CI 1.04-4.13; P=0.04), and that of tachysystole with fetal heart rate changes was decreased (RR 0.58, 95% CI 0.38-0.91; P=0.02). Frequency of cesarean did not differ (P=0.77). CONCLUSIONS: The combined use of Foley catheter and misoprostol results in a reduced time to delivery, a reduced frequency tachysystole with fetal heart rate changes, and an increased incidence of chorioamnionitis.
Authors: Howard Hao Lee; Ben-Shian Huang; Min Cheng; Chang-Ching Yeh; I-Chia Lin; Huann-Cheng Horng; Hsin-Yi Huang; Wen-Ling Lee; Peng-Hui Wang Journal: Int J Environ Res Public Health Date: 2020-03-11 Impact factor: 3.390
Authors: Rodney K Edwards; Michelle L Norris; Mitchell D West; Christina Zornes; Katherine A Loeffler; Jennifer D Peck Journal: Am J Perinatol Date: 2020-03-02 Impact factor: 3.079