Abstract：
OBJECTIVE: To compare Foley catheter insertion by digital blind method to its placement with a sterile speculum in women with unripe cervix for induction of labor.
METHODS: A systematic search was conducted in Cochrane Library, PubMed, Web of Science, and Scopus databases for randomized clinical trials (RCTs) from inception to July 2023. Included studies compared digital to speculum placement of the Foley catheter for labor induction. Data from the included studies were extracted and pooled using RevMan software for meta-analysis. The primary outcome was pain score during the procedure measured by the Visual Analog Scale (VAS). Secondary outcomes included Foley catheter insertion duration, cesarean delivery rate, induction to delivery interval, Bishop score, need for other cervical ripening methods, maternal satisfaction, and maternal fever.
RESULTS: Four RCTs involving a total of 600 patients met the inclusion criteria. Pain during the procedure and Foley catheter insertion duration were significantly reduced in the digital insertion group compared to the speculum-guided group (p < 0.05). The Bishop score showed a significant improvement in the digital Foley catheter placement group. However, there were no statistically significant differences in the cesarean delivery rate or the requirement for additional cervical ripening methods between the two groups. Maternal satisfaction with the delivery process was significantly improved in the digital insertion group (p < 0.001). Induction to delivery interval and maternal fever were comparable between both groups.
CONCLUSIONS: Digital placement of Foley catheter can be considered as an alternative to the sterile speculum method for pre-induction cervical ripening. More trials are required to confirm our findings.
METHODS: A systematic search was conducted in Cochrane Library, PubMed, Web of Science, and Scopus databases for randomized clinical trials (RCTs) from inception to July 2023. Included studies compared digital to speculum placement of the Foley catheter for labor induction. Data from the included studies were extracted and pooled using RevMan software for meta-analysis. The primary outcome was pain score during the procedure measured by the Visual Analog Scale (VAS). Secondary outcomes included Foley catheter insertion duration, cesarean delivery rate, induction to delivery interval, Bishop score, need for other cervical ripening methods, maternal satisfaction, and maternal fever.
RESULTS: Four RCTs involving a total of 600 patients met the inclusion criteria. Pain during the procedure and Foley catheter insertion duration were significantly reduced in the digital insertion group compared to the speculum-guided group (p < 0.05). The Bishop score showed a significant improvement in the digital Foley catheter placement group. However, there were no statistically significant differences in the cesarean delivery rate or the requirement for additional cervical ripening methods between the two groups. Maternal satisfaction with the delivery process was significantly improved in the digital insertion group (p < 0.001). Induction to delivery interval and maternal fever were comparable between both groups.
CONCLUSIONS: Digital placement of Foley catheter can be considered as an alternative to the sterile speculum method for pre-induction cervical ripening. More trials are required to confirm our findings.
摘要：
目的：比较Foley导管通过数字盲法插入与用无菌窥器放置在宫颈未成熟的女性引产中。
方法：在Cochrane图书馆进行了系统搜索，PubMed,WebofScience,和Scopus数据库从开始到2023年7月的随机临床试验（RCT）。纳入的研究比较了Foley导管用于引产的数字和窥器放置。从纳入的研究中提取数据，并使用RevMan软件进行荟萃分析。主要结果是通过视觉模拟量表（VAS）测量的手术过程中的疼痛评分。次要结果包括Foley导管插入持续时间,剖宫产率,诱导到交付间隔，主教得分，需要其他宫颈成熟方法，产妇满意度,和产妇发烧。
结果：4项RCT共600例患者符合纳入标准。与窥器引导组相比，数字插入组手术期间的疼痛和Foley导管插入持续时间显着减少（p<0.05）。Bishop评分显示数字Foley导管置入组显著改善。然而,两组的剖宫产率或其他促宫颈成熟方法的要求无统计学差异.数字插入组产妇对分娩过程的满意度显著提高(p<0.001)。两组之间的分娩间隔时间和产妇发热的诱导具有可比性。
结论：数字放置Foley导管可被视为用于诱导前宫颈成熟的无菌窥器方法的替代方法。需要更多的试验来证实我们的发现。
方法：在Cochrane图书馆进行了系统搜索，PubMed,WebofScience,和Scopus数据库从开始到2023年7月的随机临床试验（RCT）。纳入的研究比较了Foley导管用于引产的数字和窥器放置。从纳入的研究中提取数据，并使用RevMan软件进行荟萃分析。主要结果是通过视觉模拟量表（VAS）测量的手术过程中的疼痛评分。次要结果包括Foley导管插入持续时间,剖宫产率,诱导到交付间隔，主教得分，需要其他宫颈成熟方法，产妇满意度,和产妇发烧。
结果：4项RCT共600例患者符合纳入标准。与窥器引导组相比，数字插入组手术期间的疼痛和Foley导管插入持续时间显着减少（p<0.05）。Bishop评分显示数字Foley导管置入组显著改善。然而,两组的剖宫产率或其他促宫颈成熟方法的要求无统计学差异.数字插入组产妇对分娩过程的满意度显著提高(p<0.001)。两组之间的分娩间隔时间和产妇发热的诱导具有可比性。
结论：数字放置Foley导管可被视为用于诱导前宫颈成熟的无菌窥器方法的替代方法。需要更多的试验来证实我们的发现。
