What do systematic reviews say?

Probiotics vs placebo

Probiotics showed no clear difference in caesarean section compared with placebo (high certainty).

• Probiotics for preventing gestational diabetes 2021 · Cochrane Headline outcomes only
  RR 1 [0.86, 1.17]
  6 studies · 1520 participants
  High

Oral misoprostol vs placebo/no treatment

Oral misoprostol showed no clear difference in caesarean section compared with placebo/no treatment (low certainty).

• Low‐dose oral misoprostol for induction of labour 2021 · Cochrane Headline outcomes only
  RR 0.81 [0.59, 1.11]
  4 studies · 594 participants
  Low

Calcium supplementation/fortification vs placebo (outcomes

Calcium supplementation showed no clear difference in caesarean section compared with placebo (maternal outcomes) commencing before or early (low certainty).

• Calcium supplementation commencing before or early in pregnancy, for preventing hypertensive disorders of pregnancy 2019 · Cochrane Headline outcomes only
  RR 1.11 [0.96, 1.28]
  1 study · 578 participants
  Low

Intracervical PGE₂ vs placebo

Intracervical PGE₂ showed no clear difference in caesarean section compared with placebo (moderate certainty).

• Pharmacological and mechanical interventions for labour induction in outpatient settings 2017 · Cochrane Headline outcomes only
  RR 0.9 [0.72, 1.12]
  7 studies · 674 participants
  Moderate

Vaginal misoprostol vs placebo

Vaginal misoprostol showed no clear difference in caesarean section compared with placebo (low certainty).

• Pharmacological and mechanical interventions for labour induction in outpatient settings 2017 · Cochrane Headline outcomes only
  RR 0.94 [0.61, 1.46]
  4 studies · 325 participants
  Low

Vaginal PGE₂ vs placebo or expectant management

Vaginal PGE₂ showed no clear difference in caesarean section compared with placebo or expectant management (low certainty).

• Pharmacological and mechanical interventions for labour induction in outpatient settings 2017 · Cochrane Headline outcomes only
  RR 0.8 [0.49, 1.31]
  4 studies · 288 participants
  Low

Nitric oxide donors vs placebo

Nitric oxide donors showed no clear difference in caesarean section compared with placebo (moderate certainty).

• Nitric oxide donors for cervical ripening and induction of labour 2016 · Cochrane Headline outcomes only
  RR 0.99 [0.88, 1.11]
  9 studies · 2624 participants
  Moderate

Myo‐inositol vs placebo

• Dietary supplementation with myo‐inositol in women during pregnancy for treating gestational diabetes 2016 · Cochrane Headline outcomes only
  no estimate extracted
  0 studies · 0 participants
  GRADE not reported

PGE2 vs placebo or no treatment

PGE2 showed no clear difference in caesarean section compared with placebo or no treatment (high certainty).

• Vaginal prostaglandin (PGE2 and PGF2a) for induction of labour at term 2014 · Cochrane Headline outcomes only
  RR 0.91 [0.81, 1.02]
  36 studies · 6599 participants
  High

Beta stimulant vs placebo

Beta stimulant probably leads to lower caesarean section (primary) compared with placebo (moderate certainty).

• Interventions for helping to turn term breech babies to head first presentation when using external cephalic version 2015 · Cochrane Headline outcomes only
  RR 0.77 [0.67, 0.88]
  6 studies · 742 participants
  Moderate

Magnesium sulphate vs placebo (outcomes

Magnesium sulphate showed no clear difference in mode of birth (caesarean section)** compared with placebo (outcomes (moderate certainty).

• Magnesium sulphate for women at risk of preterm birth for neuroprotection of the fetus 2024 · Cochrane Headline outcomes only
  RR 0.96 [0.91, 1.02]
  5 studies · 5861 participants
  Moderate

Any antihypertensive drug vs no antihypertensive drugs/placebo

Any antihypertensive drug showed no clear difference in elective delivery (induction of labour + elective caesarean section) compared with no antihypertensive drugs/placebo (moderate certainty).

• Antihypertensive drug therapy for mild to moderate hypertension during pregnancy 2018 · Cochrane Headline outcomes only
  RR 0.93 [0.84, 1.04]
  4 studies · 710 participants
  Moderate