Single versus Double-Balloon Transcervical Catheter for Labor Induction: A Systematic Review and Meta-Analysis

Objective To evaluate for difference in outcomes between single- and double-balloon catheters for labor induction. Study Design We searched CINAHL, Embase, Cochrane Register, MEDLINE, ISI Web of Sciences, LILACs, and Google Scholar and retrieved studies through May 2017. Selection criteria included randomized controlled trials comparing single- versus double-balloon catheters. The primary outcome was time from catheter insertion to delivery. Heterogeneity of the results among studies was tested with the quantity I (2) . For I (2) values >= 50%, a random effects model was used to pool data across studies. Summary measures were reported as adjusted odds ratios (aORs) or as a mean difference (MD) with 95% confidence interval (CI). Results Four trials including a total of 682 patients were included: 340 patients were randomized to induction with a single-balloon catheter and 342 to induction with a double-balloon catheter. There was no significant difference between groups with respect to time to delivery (18.8 vs. 19.6 hours; MD: 0.40; 95% CI: -1.56 to 0.76), vaginal delivery rate (65.3 vs. 62.3%; aOR: 1.04; 95% CI: 0.56-1.92), cesarean delivery rate (25.6 vs. 27.5%; aOR: 0.98; 95% CI: 0.55-1.73), or epidural use (58.4 vs. 62%; aOR: 0.81; 95% CI: 0.56-1.18). Conclusion Double-balloon catheters have no apparent advantage over single-balloon catheters for labor induction.