Six vs 12-hour balloon catheter placement for the induction of labor: a systematic review and meta-analysis of randomized controlled trials

Balloon catheters have shown promising results in the induction of labor (IOL); however, evidence regarding the optimal time of balloon catheter placement is still lacking. Thus, this study aims to evaluate the efficacy and safety of 6-hour placement compared to 12 hours. We conducted a comprehensive search through a search strategy across “Embase, SCOPUS, PubMed (via MEDLINE), and Cochrane Central Register of Controlled Trials (CENTRAL)” from inception until April 20, 2024. We included the randomized controlled trials (RCTs) evaluating the efficacy and safety of 6-hour balloon catheter placement compared with 12 hours for cervical ripening in IOL. Covidence was used to screen eligible articles. All relevant outcome data were synthesized using risk ratios (RR) or mean differences (MD) with 95% confidence intervals (CIs) in meta-analysis models within RevMan 5.4. PROSPERO ID: CRD42024540935. We included five RCTs with 960 women undergoing the IOL with balloon catheter placement. Six-hour placement was associated with significant lower insertion to overall delivery interval (MD: –4.25, 95% CI [–5.34, –3.15], P