What do systematic reviews say?

Oral misoprostol vs vaginal misoprostol

Oral misoprostol showed no clear difference in apgar score less than seven at five minutes compared with vaginal misoprostol (low certainty).

• Low‐dose oral misoprostol for induction of labour 2021 · Cochrane Headline outcomes only
  RR 0.68 [0.46, 1.02]
  21 studies · 4438 participants
  Low

Oral misoprostol vs intravenous (IV) oxytocin

It is very uncertain whether oral misoprostol changes apgar score less than 7 at 5 minutes compared with intravenous oxytocin (very low certainty).

• Low‐dose oral misoprostol for induction of labour 2021 · Cochrane Headline outcomes only
  RR 2.05 [0.27, 15.7]
  4 studies · 527 participants
  Very low

Oral misoprostol vs mechanical methods

Oral misoprostol showed no clear difference in apgar score less than 7 at 5 minutes compared with mechanical methods (low certainty).

• Low‐dose oral misoprostol for induction of labour 2021 · Cochrane Headline outcomes only
  RR 1.29 [0.69, 2.39]
  4 studies · 2707 participants
  Low

Oral misoprostol vs placebo/no treatment

It is very uncertain whether oral misoprostol changes apgar score less than 7 at 5 minutes compared with placebo/no treatment (very low certainty).

• Low‐dose oral misoprostol for induction of labour 2021 · Cochrane Headline outcomes only
  RR 1.11 [0.46, 2.66]
  3 studies · 495 participants
  Very low

Oral misoprostol vs vaginal dinoprostone

Oral misoprostol showed no clear difference in apgar score less than seven at five minutes compared with vaginal dinoprostone (low certainty).

• Low‐dose oral misoprostol for induction of labour 2021 · Cochrane Headline outcomes only
  RR 0.8 [0.52, 1.23]
  12 studies · 9473 participants
  Low

Oral misoprostol one‐ to two‐hourly vs oral misoprostol four‐ to six‐hourly

• Low‐dose oral misoprostol for induction of labour 2021 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 64 participants
  Very low

Oral misoprostol 20 µg hourly titrated vs oral misoprostol 25 µg two‐hourly static

It is very uncertain whether oral misoprostol 20 µg hourly titrated changes apgar score less than 7 at 5 minutes compared with oral misoprostol 25 µg two‐hourly static (very low certainty).

• Low‐dose oral misoprostol for induction of labour 2021 · Cochrane Headline outcomes only
  RR 1 [0.32, 3.16]
  2 studies · 296 participants
  Very low