What do systematic reviews say?

Oral misoprostol vs vaginal misoprostol

Oral misoprostol may leads to lower uterine hyperstimulation with fetal heart rate changes compared with vaginal misoprostol (low certainty).

• Low‐dose oral misoprostol for induction of labour 2021 · Cochrane Headline outcomes only
  RR 0.69 [0.53, 0.92]
  25 studies · 4857 participants
  Low

Oral misoprostol vs vaginal misoprostol

Oral misoprostol may leads to lower uterine hyperstimulation without fetal heart rate changes compared with vaginal misoprostol (low certainty).

• Low‐dose oral misoprostol for induction of labour 2021 · Cochrane Headline outcomes only
  RR 0.69 [0.49, 0.99]
  16 studies · 3212 participants
  Low

Oral misoprostol vs intravenous (IV) oxytocin

It is very uncertain whether oral misoprostol changes uterine hyperstimulation with fetal heart rate changes compared with intravenous oxytocin (very low certainty).

• Low‐dose oral misoprostol for induction of labour 2021 · Cochrane Headline outcomes only
  RR 0.66 [0.19, 2.26]
  3 studies · 331 participants
  Very low

Oral misoprostol vs placebo/no treatment

It is very uncertain whether oral misoprostol changes uterine hyperstimulation with fetal heart rate changes compared with placebo/no treatment (very low certainty).

• Low‐dose oral misoprostol for induction of labour 2021 · Cochrane Headline outcomes only
  RR 5.15 [0.25, 105.31]
  3 studies · 495 participants
  Very low

Oral misoprostol vs mechanical methods

Oral misoprostol showed no clear difference in uterine hyperstimulation with fetal heart rate changes compared with mechanical methods (low certainty).

• Low‐dose oral misoprostol for induction of labour 2021 · Cochrane Headline outcomes only
  RR 1.31 [0.78, 2.21]
  4 studies · 2828 participants
  Low

Oral misoprostol vs vaginal dinoprostone

Oral misoprostol may leads to lower uterine hyperstimulation with fetal heart rate changes compared with vaginal dinoprostone (low certainty).

• Low‐dose oral misoprostol for induction of labour 2021 · Cochrane Headline outcomes only
  RR 0.49 [0.4, 0.59]
  11 studies · 9084 participants
  Low

Oral misoprostol vs mechanical methods

It is very uncertain whether oral misoprostol changes uterine hyperstimulation without fetal heart rate changes compared with mechanical methods (very low certainty).

• Low‐dose oral misoprostol for induction of labour 2021 · Cochrane Headline outcomes only
  RR 0.64 [0.3, 1.38]
  3 studies · 2506 participants
  Very low

Oral misoprostol vs placebo/no treatment

It is very uncertain whether oral misoprostol changes uterine hyperstimulation without fetal heart rate changes compared with placebo/no treatment (very low certainty).

• Low‐dose oral misoprostol for induction of labour 2021 · Cochrane Headline outcomes only
  RR 2.06 [0.39, 10.87]
  2 studies · 430 participants
  Very low

Oral misoprostol vs vaginal dinoprostone

Oral misoprostol probably leads to lower uterine hyperstimulation without fetal heart rate changes compared with vaginal dinoprostone (moderate certainty).

• Low‐dose oral misoprostol for induction of labour 2021 · Cochrane Headline outcomes only
  RR 0.83 [0.72, 0.97]
  9 studies · 8171 participants
  Moderate

Oral misoprostol vs intravenous (IV) oxytocin

It is very uncertain whether oral misoprostol changes uterine hyperstimulation without fetal heart rate changes compared with intravenous oxytocin (very low certainty).

• Low‐dose oral misoprostol for induction of labour 2021 · Cochrane Headline outcomes only
  RR 6 [0.76, 47.6]
  2 studies · 220 participants
  Very 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 one‐ to two‐hourly vs oral misoprostol four‐ to six‐hourly

It is very uncertain whether oral misoprostol one‐ to two‐hourly changes uterine hyperstimulation without fetal heart rate changes compared with oral misoprostol four‐ to six‐hourly (very low certainty).

• Low‐dose oral misoprostol for induction of labour 2021 · Cochrane Headline outcomes only
  RR 4 [0.92, 17.4]
  1 study · 64 participants
  Very low