Foley catheter balloon versus prostaglandins for cervical ripening and labor induction: a systematic review and meta-analysis

There are many methods for cervical ripening. At present, FCB and prostaglandins, including PGE2 and PGE1, are the two major methods. We conducted a meta-analysis to compare the efficiency and safety of cervical ripening and labor induction between the two methods. We performed a systematic literature search of Medline, web of science, and Cochrane library. The risk ratio (RR) with a 95% confidence interval (95% CI) was calculated using fixed-effect models or random-effect models. Eighteen randomized controlled trials were included in this meta-analysis with 3,437 patients. 1,711 participants received FCB and 1,726 participants received prostaglandins (PGE2: 1240, PGE1: 486). The FCB group and prostaglandins group had a similar risk of caesarean section, vaginal delivery in 24 h or less, 5 min Apgar score less than 5, and arterial cord pH level less than 7.10. The FCB group had a higher risk of oxytocin augmentation and the prostaglandins group had a higher risk of neonatal ICU admission. In conclusion, FCB may be safer for cervical ripening despite a higher risk of oxytocin augmentation or use.