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
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
Current version onlyBalloon (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
| Outcome | Effect | Evidence | Status / 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 participants | Low 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 participants | Moderate Downgraded: risk of bias |
Caesarean section Balloon (Foley or ATAD) vs vaginal prostaglandin E2 | RR 1 [0.92, 1.09] | 28 studies · 6619 participants | Moderate 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 participants | Moderate 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 participants | Very 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 participants | Low 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 participants | Low 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
| Outcome | Effect | Evidence | Status / 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 participants | Low 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 participants | Moderate 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 participants | Low 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 participants | Very low Downgraded: risk of bias |
Serious maternal morbidity or death Balloon (Foley or ATAD) vs low‐dose vaginal misoprostol | no estimate extracted | 4 studies · 464 participants | Very 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 participants | Low 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 participants | Low 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
| Outcome | Effect | Evidence | Status / 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 participants | Moderate 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 participants | Low 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 participants | Moderate 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 participants | Low 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 participants | Very 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 participants | Low 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 participants | Low Downgraded: risk of bias |
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
| Outcome | Effect | Evidence | Status / 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 participants | Low 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 participants | Moderate Downgraded: risk of bias |
Caesarean section Balloon (Foley or ATAD) vs vaginal prostaglandin E2 | RR 1 [0.92, 1.09] | 28 studies · 6619 participants | Moderate 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 participants | Moderate 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 participants | Very 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 participants | Low 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 participants | Low 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
| Outcome | Effect | Evidence | Status / 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 participants | Low 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 participants | Moderate 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 participants | Low 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 participants | Very low Downgraded: risk of bias |
Serious maternal morbidity or death Balloon (Foley or ATAD) vs low‐dose vaginal misoprostol | no estimate extracted | 4 studies · 464 participants | Very 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 participants | Low 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 participants | Low 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
| Outcome | Effect | Evidence | Status / 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 participants | Moderate 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 participants | Low 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 participants | Moderate 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 participants | Low 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 participants | Very 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 participants | Low 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 participants | Low Downgraded: risk of bias |