Outpatient Foley Catheter for Pre-induction Cervical Ripening in Low Risk Women: A Systematic Review [25P

Abstract

INTRODUCTION: Multiple studies have been conducted comparing inpatient versus outpatient pre-induction cervical ripening with the Foley catheter in low risk women. We performed a metanalysis and systematic review of all existing data. METHODS: This systematic review was completed via PubMed search. Articles published prior to July 31, 2019 were included for review. We included two randomized control trials, one pilot randomized control trial, a clinical cohort study, and a retrospective cohort study in our review which met the following criteria: 1) compared outpatient versus inpatient use of Foley catheter for pre-induction cervical ripening in low-risk women at term (>37 weeks), Bishop score <5, cephalic presentation with an unfavorable cervix 2) detailed maternal and neonatal outcomes 3) full article text was available 4) article published in English. Five maternal and two neonatal primary outcomes were captured for analysis. Meta-analysis was completed via Stata v15.1 software. RESULTS: Five studies were included with 1,346 subjects. The final Bishop score, oxytocin infusion time, and induction-to-delivery time were greater in the outpatient group (Table 1, P<.05). However, there was no difference in cesarean delivery, vaginal delivery, initial Bishop score, NICU admission, and Apgar score <7 at 5 minutes between the outpatient and inpatient groups. CONCLUSION: In this large cohort, outcomes between low risk women who received the Foley catheter for pre-induction cervical ripening in the outpatient and inpatient setting were similar.