Misoprostol combined with cervical single or double balloon catheters versus misoprostol alone for labor induction of singleton pregnancies: a meta-analysis of randomized trials

AbstractObjective: To compare the effect of misoprostol combined with a cervical single or double-balloon catheter versus misoprostol alone for labor induction of singleton pregnancies with an unfavorable cervix.Methods: Systematic review and meta-analysis of randomized controlled trials (RCTs) regarding the comparison of two schemes for labor induction of singleton cephalic pregnancies with a Bishop score ≤7 and no contraindication for vaginal delivery. Six research databases were searched for articles published in all languages up to 10 May 2018 comparing misoprostol (oral or vaginal) in combination with a cervical placed single or double balloon catheter versus misoprostol treatment alone. Random effects models and inverse variance were used for meta-analyses. Summary measures were mean differences (MDs) and risk ratios (RRs) with 95% confidence interval (CI). Risk of bias was evaluated with the Cochrane tool and publication bias was assessed with Begg’s and Egger’s tests.Results: Fifteen RCTs reported...