Objective: To assess the efficacy of reducing the duration of intrauterine balloons placement from 12 h to 6 h for labor induction, specifically in terms of reducing the time from balloon placement to delivery and the rate of cesarean delivery.
Methods: Comprehensive searches were conducted across the Cochrane Library, Web of Science, PubMed, ClinicalTrials.gov, and Embase from their inception until August 2024. Randomized controlled trials (RCTs) incorporated into our meta-analysis involved nulliparous and multiparous women with an unfavorable cervix requiring labor induction, where the intervention was intrauterine balloon placement for 6 h, compared with the placement for 12 h, and the outcomes included the time from balloon placement to delivery, the rate of cesarean delivery, and maternal and neonatal adverse outcomes. The Cochrane risk-of-bias assessment tool was used to appraise the quality of the studies incorporated in our analysis. The meta-analysis was executed using RevMan 5.3 statistical software. Heterogeneity among the selected studies was assessed using the I statistic. Dichotomous outcomes were expressed as relative risk (RR) with corresponding 95% confidence intervals (CI), while continuous outcomes were represented as the mean difference (MD).
Results: A total of six studies, encompassing a total of 1,160 nulliparous and multiparous women with an unfavorable cervix, were incorporated into the systematic review. In comparison to the 12-hours groups, women in 6-hours group experienced a significantly shorter interval from intrauterine balloon placement to delivery (MD = -3.67, 95 %CI: -4.73, -2.62, P<0.00001), and a reduced rate of cesarean delivery (RR = 0.83, 95 %CI: 0.71, 0.98, P = 0.02). Additionally, no statistically significant differences were noted in maternal and neonatal adverse outcomes between the two groups.
Conclusions: These findings substantiate the potential benefits of reducing the duration of intrauterine balloons usage from 12 to 6 h during labor induction.
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