- Times to delivery differ little between balloon vs pharmacologic medication for induction of labor (IOL), according to this Cochrane review.
- Reduced risk for uterine hyperstimulation is seen with balloon.
Why this matters
- Induction increases hospitalization time and time to delivery.
- Balloon vs prostaglandin (PGE2):
- Rate of vaginal delivery not achieved within 24 hours is not significantly different.
- Balloon vs low-dose vaginal misoprostol:
- Balloon catheter reduces risk for hyperstimulation.
- Balloon vs low-dose oral misoprostol:
- Rate of vaginal delivery not achieved within 24 hours is slightly higher with balloon.
- Systematic review.
- Clinical trials comparing methods for cervical ripening or IOL were included (113 trials; 22,373 participants).
- Primary outcomes included vaginal deliveries not achieved within 24 hours and uterine hyperstimulation with fetal heart rate abnormalities.
- Safety was examined using numerous measures.
- Mechanical methods: defined as balloon, laminaria, Dilapan, injected fluid in the extra-amniotic space.
- Pharmacological methods: defined as PGE2 and low-dose misoprostol.
- Balloon: defined as Foley or "Atad" (double balloon or Cook catheter).
- Funding: University of Geneva; Netherlands Organisation for Scientific Research.
- This review defines a balloon catheter as a "mechanical method," but its main function may be the release of prostaglandins.