Zaman Amal Yaseen, Hassan Howaida Amin, Reddy Nageshwar Venkatesh, Begum Farzana, Mahmoud Samar Ahmed, Alghamdi Hayat, AbdAllah Hussein Naglaa Kamel, Elhussain Mariam Yousif, Alnassry Soad Mohamed, Merghani Magda Mubarak, Musa Manal Elzein, Mohammed Hanan Mohammed, Fadlalmola Hammad Ali
Department of Obstetrics and Gynecology, College of Medicine, Taibah University, Madinah 42353, Saudi Arabia.
Department of Obstetrics and Gynecological Nursing, Alriyada College for Health Sciences, Jeddah 23332, Saudi Arabia.
Healthcare (Basel). 2025 Apr 24;13(9):983. doi: 10.3390/healthcare13090983.
: Labor induction is increasing in obstetric practice. In women with an unfavorable cervix, cervical ripening is required for successful induction. We conducted this review to compare the effectiveness and tolerance of two interventions used for cervical ripening, topical prostaglandin E2 (dinoprostone) and transcervical Foley's catheter. : We systematically searched four biomedical databases on 15 November 2024, for relevant studies. The studies' eligibility was determined after screening their titles, abstracts, and full texts. We extracted relevant data from the studies included. RevMan software V5.4 was used to conduct the random-effect meta-analysis. Misoprostol was excluded from this review due to variability in dosing protocols and inconsistent reporting across studies. A review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO), registration number: CRD420251026183. : This review included 41 studies that in total enrolled 12,877 women (6722 for Foley's catheter and 6155 for dinoprostone). The efficacy of the two interventions was comparable as evidenced by the similarity in the induction to delivery time, Bishop score change, the rate of vaginal delivery within 24 h, and the risk of induction failure. Foley's catheter was linked with lower risks of caesarian delivery (RR = 0.84, = 0.006), uterine hyperstimulation (RR = 0.39, < 0.001), postpartum hemorrhage (RR = 0.76, = 0.03), and a 1-min Apgar score < 7 (RR = 0.75, = 0.02). However, it was associated with an extra need for oxytocin augmentation (RR = 1.18, < 0.001). The risks of instrumental delivery, intrapartum pyrexia, postpartum infection, meconium passage, umbilical cord arterial pH < 7.1, a 5-min Apgar score < 7, and neonatal intensive care requirement were comparable for the two interventions. : In comparison with dinoprostone, Foley's catheter is equally effective and well tolerated. We recommend Foley's catheter use for women with a previous caesarian delivery and in low-resource settings.
引产在产科实践中日益增多。对于宫颈条件不佳的女性，成功引产需要宫颈成熟。我们进行这项综述以比较用于宫颈成熟的两种干预措施——局部使用前列腺素E2（地诺前列酮）和经宫颈放置Foley导管——的有效性和耐受性。
我们于2024年11月15日系统检索了四个生物医学数据库以查找相关研究。在筛选研究的标题、摘要和全文后确定其纳入资格。我们从纳入的研究中提取相关数据。使用RevMan软件V5.4进行随机效应荟萃分析。由于给药方案的变异性以及各研究报告不一致，米索前列醇被排除在本综述之外。一项综述方案已在国际前瞻性系统评价注册库（PROSPERO）注册，注册号：CRD420251026183。
本综述纳入了41项研究，共纳入12,877名女性（6722名使用Foley导管，6155名使用地诺前列酮）。两种干预措施的有效性相当，引产至分娩时间、Bishop评分变化、24小时内阴道分娩率以及引产失败风险相似均证明了这一点。Foley导管与剖宫产风险较低（RR = 0.84，P = 0.006）、子宫过度刺激风险较低（RR = 0.39，P < 0.001）、产后出血风险较低（RR = 0.76，P = 0.03）以及1分钟Apgar评分<7的风险较低（RR = 0.75，P = 0.02）相关。然而，它与额外需要催产素加强宫缩相关（RR = 1.18，P < 0.001）。两种干预措施在器械助产、产时发热、产后感染、胎粪排出、脐动脉pH<7.1、5分钟Apgar评分<7以及新生儿重症监护需求方面的风险相当。
与地诺前列酮相比，Foley导管同样有效且耐受性良好。我们建议既往有剖宫产史的女性以及在资源匮乏地区的女性使用Foley导管。
