Ahmed Mohamed Abdelhakim1, Mohammad Abrar Shareef2, Abdulhadi A AlAmodi3, Rehab Abdelhamid Aboshama4, Mohamed Fathi1, Ahmed M Abbas5. 1. Kasralainy, Faculty of Medicine, Cairo University, Cairo, Egypt. 2. Department of Family Medicine, Sebasticook Valley Hospital, Pittsfield, ME, USA. 3. School of Public Health, Jackson State University, Jackson, MS, USA. 4. Department of Obstetrics and Gynecology, Faculty of Medicine, Fayoum University, Fayoum, Egypt. 5. Department of Obstetrics and Gynecology, Faculty of Medicine, Assiut University, Egypt. Electronic address: bmr90@hotmail.com.
Abstract
OBJECTIVE: To compare between outpatient and inpatient balloon catheter insertion for labor induction. METHODS: We searched in four different databases for the available trials during May 2020. We included randomized controlled trials (RCTs) that compared outpatient to inpatient balloon catheter for induction of labor. We extracted the available data from the included studies and pooled them in meta-analysis using RevMan software. The dichotomous data were pooled as risk ratio (RR) and the continuous data were pooled as mean difference (MD) with the corresponding 95% confidence intervals (CI).Our primary outcome was the rate of cesarean delivery. Our secondary outcomes were the length of hospital stay, Bishop score, and different adverse events including postpartum hemorrhage, Apgar score less than 7 at 5 minutes, and chorioamnionitis. RESULTS: Eight RCTs with a total number of 740patients were included. The cesarean delivery rate was significantly reduced among outpatient balloon catheter compared to inpatient balloon catheter (RR = 0.63, 95% CI [0.46, 0.86], p = 0.004). Outpatient balloon catheter was associated with shorter hospital stay duration in comparison with inpatient group (MD= -0.38, 95% CI [-0.61, -0.14], p = 0.002). Outpatient group was linked to a more favorable increase in Bishop score (MD = 0.88, 95% CI [0.78, 0.98], p>0.001). There were no significant differences between both groups regarding different adverse events. CONCLUSION: Outpatient balloon catheter priming is safe and effective in reducing cesarean delivery rates and shortening the length of hospital stay with a better Bishop score.
OBJECTIVE: To compare between outpatient and inpatient balloon catheter insertion for labor induction. METHODS: We searched in four different databases for the available trials during May 2020. We included randomized controlled trials (RCTs) that compared outpatient to inpatient balloon catheter for induction of labor. We extracted the available data from the included studies and pooled them in meta-analysis using RevMan software. The dichotomous data were pooled as risk ratio (RR) and the continuous data were pooled as mean difference (MD) with the corresponding 95% confidence intervals (CI).Our primary outcome was the rate of cesarean delivery. Our secondary outcomes were the length of hospital stay, Bishop score, and different adverse events including postpartum hemorrhage, Apgar score less than 7 at 5 minutes, and chorioamnionitis. RESULTS: Eight RCTs with a total number of 740patients were included. The cesarean delivery rate was significantly reduced among outpatient balloon catheter compared to inpatient balloon catheter (RR = 0.63, 95% CI [0.46, 0.86], p = 0.004). Outpatient balloon catheter was associated with shorter hospital stay duration in comparison with inpatient group (MD= -0.38, 95% CI [-0.61, -0.14], p = 0.002). Outpatient group was linked to a more favorable increase in Bishop score (MD = 0.88, 95% CI [0.78, 0.98], p>0.001). There were no significant differences between both groups regarding different adverse events. CONCLUSION:Outpatient balloon catheter priming is safe and effective in reducing cesarean delivery rates and shortening the length of hospital stay with a better Bishop score.