title: Double-balloon catheter versus prostaglandin E2 for cervical ripening and labour induction: a systematic review and meta-analysis of randomised controlled trials.
abstract: BACKGROUND
  Induction of labour has become an increasingly common procedure. Ripening methods, including mechanical devices and pharmacological agents, improve the success rate of labour induction.
  
  
  OBJECTIVE
  To compare the efficacy and safety of the double-balloon catheter with prostaglandin E2 agents used for labour induction.
  
  
  METHODS
  We searched electronic sources from MEDLINE, Embase and Web of Science, the Cochrane Library Database of Systematic Reviews, and ClinicalTrials.gov website.
  
  
  METHODS
  Only randomised controlled trials comparing the PGE2 agents with the double-balloon catheter for cervical ripening and labour induction in women with unfavourable cervices were included in the analysis.
  
  
  METHODS
  The main outcomes included the vaginal delivery rate within 24 hours and risk of caesarean section. We calculated relative risks and mean differences using fixed- and random-effects models.
  
  
  RESULTS
  Nine studies (1866 patients) were included in this systematic review. Both the double-balloon catheter and PGE2 agents were comparable with regard to rate of caesarean section (RR 0.92; 95% CI 0.79, 1.07), vaginal delivery within 24 hours (RR 0.95; 95% CI 0.78, 1.16) and maternal adverse events, but the risk of excessive uterine activity (RR 10.02; 95% CI 3.99, 25.17) and need for neonatal intensive care unit admissions (RR 1.31; 95% CI 1.01, 1.69) were significantly increased in women who received PGE2 agents.
  
  
  CONCLUSIONS
  The double-balloon catheter demonstrated greater safety and cost-effectiveness than PGE2 agents for cervical ripening and labour induction. The efficacy profiles of both methods were similar.
  
  
  CONCLUSIONS
  Double-balloon catheter versus prostaglandin E2 for cervical ripening and labour induction.
authors.affiliation: Department of Obstetrics & Gynaecology, Ningbo First Hospital, Ningbo, Zhejiang, China.
authors.forename: Y M
authors.initials: YM
authors.lastname: Du
authors.affiliation: Department of Obstetrics & Gynaecology, Ningbo First Hospital, Ningbo, Zhejiang, China.
authors.forename: L Y
authors.initials: LY
authors.lastname: Zhu
authors.affiliation: Department of Obstetrics & Gynaecology, Ningbo First Hospital, Ningbo, Zhejiang, China.
authors.forename: L N
authors.initials: LN
authors.lastname: Cui
authors.affiliation: Department of Obstetrics & Gynaecology, Ningbo First Hospital, Ningbo, Zhejiang, China.
authors.forename: B H
authors.initials: BH
authors.lastname: Jin
authors.affiliation: Department of Obstetrics & Gynaecology, Ningbo First Hospital, Ningbo, Zhejiang, China.
authors.forename: J L
authors.initials: JL
authors.lastname: Ou
mesh_terms: D000328:Adult; D057785:Catheters / Q000706:statistics & numerical data*; D020070:Cervical Ripening; D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D015232:Dinoprostone / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007751:Labor, Induced / Q000379:methods*; D010120:Oxytocics / Q000008:administration & dosage*; D011247:Pregnancy; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
chemical_list: D010120:Oxytocics; D015232:Dinoprostone
keywords: Cervical ripening; double-balloon catheter; induction of labour; prostaglandin E2