Comparison of Double Balloon Catheter and Dinoprostone Vaginal Insert in Induced Labor: A Meta-Analysis of 2267 Patients

Background: Labor induction is a common procedure in obstetrics, with various methods employed to facilitate the process. This study aimed to compare the effects of labor induction using the double-balloon catheter (DBC) and dinoprostone (D), two widely used methods in clinical practice. Methods: Randomized controlled trials (RCTs) were identified from the Cochrane Library, SinoMed, PUBMED, and Embase up to March 2024. Two researchers independently screened and extracted the literature according to the inclusion and exclusion criteria. After evaluating the literature, Revman 5.4 software was used to analyze the data. The time to the onset of active labor and the rate of cesarean deliveries were the key outcomes. The secondary outcomes included assisted vaginal delivery, failure to progress rate, failed induction rate, incidence of nonreassuring fetal heart rate, neonatal asphyxia incidence, neonatal intensive care unit (NICU) admission rate, improvement in time to onset of active labor, time to vaginal delivery, Bishop score, need for oxytocin administration, presence of postpartum hemorrhage, vaginal delivery within 24 hours, and uterine hyperstimulation rate. Results: The total of 7 RCTs involving 2267 patients were included, with 1127 treated with DBC, and 1140 treated with D. Our meta-analysis showed no significant difference between the two groups in terms of cesarean delivery [odds ratio (OR) = 1.10, 95% confidence interval (95% CI): 0.91, 1.32, p = 0.34], time to onset of active labor [mean difference (MD) = 0.66, 95% CI: –4.72, 6.03, p = 0.81], presence of nonreasuring fetal heart, success rate of induction, improvement in Bishop score, rate of progress in labor, vaginal delivery rate within 24 hours, time to vaginal delivery, postpartum hemorrhage, and assisted vaginal delivery. Although the oxytocin administration rate (OR = 3.96, 95% CI: 3.18, 4.93, p < 0.00001) was lower, D was more likely to cause uterine hyperstimulation, leading to a higher rate of neonatal asphyxia (OR = 0.39, 95% CI: 0.18, 0.85, p = 0.02). Conclusions: Compared to DBC, D was more likely to cause uterine hyperstimulation, leading to a higher rate of neonatal asphyxia.