Cochrane · systematic review · CD001233

Mechanical methods for induction of labour

de Vaan, MDT, ten Eikelder, MLG, Jozwiak, M, et al. · Cochrane Database of Systematic Reviews · 2023 · Cochrane Library

Pregnancy and Childbirth2 versionsAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
21
current version
GRADE rated
21
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 4 · 19%Low 11 · 52.4%Moderate 6 · 28.6%High 0 · 0%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Questions and results

Show all 2 versions

Balloon (Foley or ATAD) compared to vaginal prostaglandin E2 for third trimester labour induction in women with a viable fetus

Population: third trimester labour induction in women with a viable fetus
7 questions
OutcomeEffectEvidenceStatus / GRADE
Vaginal delivery not achieved in 24 hours
Balloon (Foley or ATAD) vs vaginal prostaglandin E2
RR 1.01 [0.82, 1.26]7 studies · 1685 participantsLow
Downgraded: risk of bias
Uterine hyperstimulation with FHR changes
Balloon (Foley or ATAD) vs vaginal prostaglandin E2
RR 0.35 [0.18, 0.67]6 studies · 1966 participantsModerate
Downgraded: risk of bias
Caesarean section
Balloon (Foley or ATAD) vs vaginal prostaglandin E2
RR 1 [0.92, 1.09]28 studies · 6619 participantsModerate
Downgraded: risk of bias
Serious neonatal morbidity or perinatal death
Balloon (Foley or ATAD) vs vaginal prostaglandin E2
RR 0.48 [0.25, 0.93]8 studies · 2757 participantsModerate
Downgraded: risk of bias
Serious maternal morbidity or death
Balloon (Foley or ATAD) vs vaginal prostaglandin E2
RR 0.2 [0.01, 4.12]4 studies · 1481 participantsVery low
Downgraded: risk of bias
Apgar score < 7 at 5 minutes
Balloon (Foley or ATAD) vs vaginal prostaglandin E2
RR 0.74 [0.49, 1.14]14 studies · 4271 participantsLow
Downgraded: risk of bias
Neonatal intensive care unit admission
Balloon (Foley or ATAD) vs vaginal prostaglandin E2
RR 0.82 [0.65, 1.04]12 studies · 3647 participantsLow
Downgraded: risk of bias

Balloon (Foley or ATAD) compared to low‐dose vaginal misoprostol for third trimester induction of labour in women with a viable fetus

Population: third trimester induction of labour in women with a viable fetus
7 questions
OutcomeEffectEvidenceStatus / GRADE
Vaginal delivery not achieved in 24 hours
Balloon (Foley or ATAD) vs low‐dose vaginal misoprostol
RR 1.09 [0.85, 1.39]2 studies · 340 participantsLow
Downgraded: risk of bias
Uterine hyperstimulation with FHR changes
Balloon (Foley or ATAD) vs low‐dose vaginal misoprostol
RR 0.39 [0.18, 0.85]8 studies · 1322 participantsModerate
Downgraded: risk of bias
Caesarean section
Balloon (Foley or ATAD) vs low‐dose vaginal misoprostol
RR 1.28 [1.02, 1.6]12 studies · 1756 participantsLow
Downgraded: risk of bias
Serious neonatal morbidity or perinatal death
Balloon (Foley or ATAD) vs low‐dose vaginal misoprostol
RR 0.58 [0.12, 2.66]3 studies · 381 participantsVery low
Downgraded: risk of bias
Serious maternal morbidity or death
Balloon (Foley or ATAD) vs low‐dose vaginal misoprostol
no estimate extracted4 studies · 464 participantsVery low
Downgraded: risk of bias
Apgar score < 7 at 5 minutes
Balloon (Foley or ATAD) vs low‐dose vaginal misoprostol
RR 1 [0.5, 1.97]7 studies · 941 participantsLow
Downgraded: risk of bias
Neonatal intensive care unit admission
Balloon (Foley or ATAD) vs low‐dose vaginal misoprostol
RR 1 [0.61, 1.63]9 studies · 1302 participantsLow
Downgraded: risk of bias

Balloon (Foley or ATAD) compared to low‐dose oral misoprostol for third trimester induction of labour in women with a viable fetus

Population: third trimester induction of labour in women with a viable fetus
7 questions
OutcomeEffectEvidenceStatus / GRADE
Vaginal delivery not achieved within 24 hours
Balloon (Foley or ATAD) vs low‐dose oral misoprostol
RR 1.28 [1.13, 1.46]2 studies · 782 participantsModerate
Downgraded: risk of bias
Uterine hyperstimulation with FHR changes
Balloon (Foley or ATAD) vs low‐dose oral misoprostol
RR 0.81 [0.48, 1.38]2 studies · 2033 participantsLow
Downgraded: risk of bias
Caesarean section
Balloon (Foley or ATAD) vs low‐dose oral misoprostol
RR 1.17 [1.04, 1.32]7 studies · 3178 participantsModerate
Downgraded: risk of bias
Serious neonatal morbidity or perinatal death
Balloon (Foley or ATAD) vs low‐dose oral misoprostol
RR 1.11 [0.6, 2.06]3 studies · 2627 participantsLow
Downgraded: risk of bias
Serious maternal morbidity or death
Balloon (Foley or ATAD) vs low‐dose oral misoprostol
RR 0.5 [0.05, 5.52]3 studies · 2627 participantsVery low
Downgraded: risk of bias
Apgar score < 7 after 5 minutes
Balloon (Foley or ATAD) vs low‐dose oral misoprostol
RR 0.71 [0.38, 1.32]4 studies · 2693 participantsLow
Downgraded: risk of bias
Neonatal intensive care unit admission
Balloon (Foley or ATAD) vs low‐dose oral misoprostol
RR 0.82 [0.58, 1.17]5 studies · 2873 participantsLow
Downgraded: risk of bias