目的:球囊导管在引产(IOL)中显示出有希望的结果;然而,关于球囊导管放置的最佳时间的证据仍然缺乏。因此,本研究旨在评估6小时与12小时相比的疗效和安全性.
方法:我们通过搜索策略在\"Embase,Scopus,PubMed(通过MEDLINE),和Cochrane中央控制试验登记册(CENTRAL)\“从开始到2024年4月20日。
方法:我们纳入了随机对照试验(RCT),评估了6小时球囊导管放置与12小时人工晶状体宫颈成熟的疗效和安全性。Covidence用于筛选合格的文章。
方法:在RevMan5.4中的meta分析模型中,使用风险比(RR)或平均差异(MD)和95%置信区间(CI)合成所有相关结果数据。
■CRD42024540935结果:我们纳入了5项随机对照试验,其中960名女性接受了人工晶状体球囊导管置入术。6小时放置与插入到总分娩间隔显著降低相关(MD:-4.25,95%CI[-5.34,-3.15],P<0.00001)和插入阴道分娩间隔(MD:-4.65,95%CI[-6.08,-3.23],P<0.00001)BISHOP评分变化无显著差异(MD:-0.02,95%CI[-0.23,0.20],P=0.88),导管拔除至分娩间隔(MD:0.72,95%CI[-0.39,1.83],P=0.20)和催产素输注的总持续时间(MD:-0.36,95%CI[-0.85,0.14],P=0.16)与12小时相比。此外,剖宫产率显著降低(RR:0.81,95%CI[0.68,0.96],P=0.01)和由于不表达引起的CD(RR:0.39,95%CI[0.16,0.93],6小时放置时观察到P=0.03)。
结论:计划的6小时球囊导管放置减少了插入到分娩间隔和CD率,与12小时相比,在BISHOP评分变化和导管移除到分娩间隔方面具有同等疗效。
OBJECTIVE: Balloon catheters have shown promising results in the induction of labor (IOL); however, evidence regarding the optimal time of balloon catheter placement is still lacking. Thus, this study aims to evaluate the efficacy and safety of six-hour placement compared to 12 hours.
METHODS: We conducted a comprehensive search through a search strategy across \"Embase, SCOPUS, PubMed (via MEDLINE), and Cochrane Central Register of Controlled Trials (CENTRAL)\" from inception until April 20, 2024.
METHODS: We included the randomized controlled trials (RCTs) evaluating the efficacy and safety of six-hour balloon catheter placement compared with 12 hours for cervical ripening in IOL. Covidence was used to screen eligible articles.
METHODS: All relevant outcome data were synthesized using risk ratios (RR) or mean differences (MD) with 95% confidence intervals (CIs) in meta-analysis models within RevMan 5.4.
UNASSIGNED: CRD42024540935 RESULTS: We included five RCTs with 960 women undergoing the IOL with balloon catheter placement. Six-hour placement was associated with significant lower insertion to overall delivery interval (MD: -4.25, 95% CI [-5.34, -3.15], P< 0.00001) and insertion to vaginal delivery interval (MD: -4.65, 95% CI [-6.08, -3.23], P< 0.00001) without significant difference in BISHOP score change (MD: -0.02, 95% CI [-0.23, 0.20], P= 0.88), catheter removal to delivery interval (MD: 0.72, 95% CI [-0.39, 1.83], P= 0.20) and total duration of oxytocin infusion (MD: -0.36, 95% CI [-0.85, 0.14], P= 0.16) compared to twelve hours. Also, significantly lower overall cesarean delivery (CD) rate (RR: 0.81, 95% CI [0.68, 0.96], P= 0.01) and CD due to malpresentation (RR: 0.39, 95% CI [0.16, 0.93], P= 0.03) were observed with six-hour placement.
CONCLUSIONS: A planned six-hour balloon catheter placement reduced insertion to delivery intervals and CD rate and has equal efficacy in BISHOP score change and catheter removal to delivery interval compared to twelve hours.