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Foley catheter vs oral misoprostol for induction of labor: individual participant data meta‐analysis
- Source :
- Ultrasound in Obstetrics & Gynecology. 57:215-223
- Publication Year :
- 2021
- Publisher :
- Wiley, 2021.
-
Abstract
- Objective To compare the effectiveness and safety of Foley catheter and oral misoprostol for induction of labor (IOL). Methods The Cochrane Review on Mechanical Methods for Induction of Labour and Ovid MEDLINE, EMBASE via Ovid, Ovid Emcare, CINAHL Plus, ClinicalTrials.gov and Scopus, from inception to April 2019, were searched for randomized controlled trials (RCTs) comparing Foley catheter to oral misoprostol for IOL in viable singleton gestations. Eligible trials for which raw data were obtained were included and individual participant data meta-analysis was performed. Primary outcomes were vaginal birth, a composite of adverse perinatal outcome (including stillbirth, neonatal death, neonatal seizures, admission to the neonatal intensive care unit, severe respiratory compromise or meconium aspiration syndrome) and a composite of adverse maternal outcome (including admission to the intensive care unit, maternal infection, severe postpartum hemorrhage, maternal death or uterine rupture). The quality of the included RCTs was assessed using the Cochrane Risk of Bias 2 tool and the certainty of evidence was evaluated using the GRADE approach. A two-stage random-effects model was used for meta-analysis according to the intention-to-treat principle and interactions between treatment and baseline characteristics were assessed. Results Of seven eligible trials, four provided individual participant data for a total of 2815 participants undergoing IOL, of whom 1399 were assigned to Foley catheter and 1416 to oral misoprostol. All four trials provided data for each of the primary outcomes in all 2815 women. Compared with those receiving oral misoprostol, Foley catheter recipients had a slightly decreased chance of vaginal birth (risk ratio (RR), 0.95 (95% CI, 0.91-0.99); I2 , 2.0%; moderate-certainty evidence). A trend towards a lower rate of composite adverse perinatal outcome was found in women undergoing IOL using a Foley catheter compared with oral misoprostol (RR, 0.71 (95% CI, 0.48-1.05); I2 , 14.9%; low-certainty evidence). Composite adverse maternal outcome did not differ between the groups (RR, 1.00 (95% CI, 0.97-1.03); I2 , 0%; moderate-certainty evidence). Meta-analyses of effect modifications did not show significant interactions between intervention and parity or gestational age for any of the primary outcomes. Conclusions For women undergoing IOL, Foley catheter is less effective than oral misoprostol, as it was associated with fewer vaginal births. However, while we found no significant difference in maternal safety, Foley catheter induction may reduce adverse perinatal outcomes. Copyright © 2020 ISUOG. Published by John Wiley & Sons Ltd.
- Subjects :
- medicine.medical_specialty
Catheters
Neonatal intensive care unit
Foley catheter
Administration, Oral
law.invention
03 medical and health sciences
0302 clinical medicine
Randomized controlled trial
Pregnancy
law
Oxytocics
medicine
Humans
Radiology, Nuclear Medicine and imaging
Labor, Induced
030212 general & internal medicine
Misoprostol
Randomized Controlled Trials as Topic
030219 obstetrics & reproductive medicine
Radiological and Ultrasound Technology
Obstetrics
business.industry
Obstetrics and Gynecology
Gestational age
General Medicine
16. Peace & justice
medicine.disease
Intensive care unit
3. Good health
Reproductive Medicine
Relative risk
Female
Maternal death
Urinary Catheterization
business
medicine.drug
Subjects
Details
- ISSN :
- 14690705 and 09607692
- Volume :
- 57
- Database :
- OpenAIRE
- Journal :
- Ultrasound in Obstetrics & Gynecology
- Accession number :
- edsair.doi.dedup.....74d465ade5238bdc01e30033b166b28c