Chongqing Health Center for Women and Children, No. 120 LongShan Road, Yubei District, Chongqing, 401147, China.
Arch Gynecol Obstet. 2019 Jan;299(1):7-12. doi: 10.1007/s00404-018-4929-8. Epub 2018 Oct 12.
To assess the efficacy and safety of a double-balloon catheter versus dinoprostone insert for labour induction.
PubMed, MEDLINE, Embase, ClinicalTrials.gov, and the Cochrane Central Register of Clinical Trials databases were searched from 1985 to April 2018. Randomized controlled trials that compared a double-balloon catheter and dinoprostone insert for cervical ripening were identified. Eligible study populations consisted of women with singleton pregnancies that had any indication for labour induction and were randomly assigned to undergo induction with a double-balloon catheter or dinoprostone insert. The main outcomes were incidence of vaginal delivery within 24 h and caesarean section, and neonatal outcomes.
Five randomized trials (603 women; 305 with a double-balloon catheter and 298 with a dinoprostone insert) were eligible for inclusion. No differences were observed between the two groups in terms of vaginal delivery within 24 h [relative risk (RR) 1.21, 95% confidence interval (CI) 0.93-1.59] and incidence of caesarean section (RR 0.99, 95% CI 0.77-1.27). Compared with the double-balloon catheter, the dinoprostone insert was associated with a reduced need for oxytocin administration in the process of labour induction (RR 1.95, 95% CI 1.45-2.62). However, there was a higher incidence of excessive uterine activity (RR 0.17, 95% CI 0.06-0.54) and neonatal umbilical cord arterial blood pH < 7.1 (RR 0.36, 95% CI 0.15-0.84) in the dinoprostone insert group.
This review showed that the efficacy of labour induction using both the double-balloon catheter and dinoprostone insert was similar. However, the double-balloon catheter seemed to be a safer method.
评估双球囊导管与地诺前列酮栓用于引产的疗效和安全性。
检索 1985 年至 2018 年 4 月期间的 PubMed、MEDLINE、Embase、ClinicalTrials.gov 和 Cochrane 临床试验中心注册库，纳入比较双球囊导管与地诺前列酮栓用于宫颈成熟的随机对照试验。合格的研究人群包括有引产指征的单胎妊娠妇女，随机分配至双球囊导管或地诺前列酮栓引产组。主要结局为 24 小时内阴道分娩率和剖宫产率以及新生儿结局。
纳入 5 项随机试验（603 名妇女；双球囊导管组 305 名，地诺前列酮栓组 298 名）。两组 24 小时内阴道分娩率[相对危险度（RR）1.21，95%置信区间（CI）0.93-1.59]和剖宫产率（RR 0.99，95% CI 0.77-1.27）无差异。与双球囊导管相比，地诺前列酮栓引产过程中催产素使用率较低（RR 1.95，95% CI 1.45-2.62）。然而，地诺前列酮栓组子宫过度活动发生率较高（RR 0.17，95% CI 0.06-0.54），新生儿脐动脉血 pH 值<7.1 的发生率较高（RR 0.36，95% CI 0.15-0.84）。
本综述显示，双球囊导管与地诺前列酮栓引产的效果相似，但双球囊导管似乎更为安全。
