Controlled-release dinoprostone insert versus Foley catheter for labor induction: a meta-analysis

Area of Science:

• Obstetrics and Gynecology
• Reproductive Medicine
• Clinical Pharmacology

Background:

• Cervical ripening and labor induction are critical in managing pregnancy complications.
• Controlled-release dinoprostone insert and Foley catheter balloon are common methods for cervical ripening.
• Evidence comparing their effectiveness and safety is crucial for clinical decision-making.

Purpose of the Study:

• To compare the effectiveness and safety of controlled-release dinoprostone insert versus Foley catheter balloon for cervical ripening and labor induction.
• To analyze key outcomes including time to delivery, delivery rates, and adverse events.

Main Methods:

• A systematic review and meta-analysis of randomized controlled trials (RCTs).
• Searches conducted in PubMed, Cochrane, Web of Science, and China Knowledge Resource Integrated Database.
• Data synthesized using risk ratios (RR) and mean differences (MD) with 95% confidence intervals (CI).

Main Results:

• Six RCTs involving 731 women (dinoprostone) and 722 women (Foley catheter) were analyzed.
• Dinoprostone insert significantly shortened the time from induction to delivery (MD 5.73 h).
• No significant differences were observed in vaginal delivery within 24 hours or cesarean section rates. Dinoprostone was associated with increased excessive uterine contractions but less oxytocin use.

Conclusions:

• Controlled-release dinoprostone insert demonstrates greater effectiveness in labor induction compared to the Foley catheter.
• The use of dinoprostone insert is linked to a higher incidence of excessive uterine contractions.
• Further research may be warranted to optimize safety profiles and patient selection for each method.