Cochrane · systematic review · CD009792
Methods of term labour induction for women with a previous caesarean section
West, HM, Jozwiak, M, Dodd, JM · Cochrane Database of Systematic Reviews · 2017 · Cochrane Library
Pregnancy and ChildbirthAMSTAR 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
40
current version
GRADE rated
12
No studies
28
Included studies
NR
No studies 28 · 70%Ungraded 0 · 0%Very low 3 · 7.5%Low 7 · 17.5%Moderate 2 · 5%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
Vaginal PGE2 versus intravenous (IV) oxytocin
Population: women with one previous lower segment caesarean section and requiring labour induction due to prolonged pregnancy or pre‐eclampsia, singleton in cephalic presentation, GA ≥ 37 weeks, BS < 9, no cephalopelvic disproportion anticipated
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Vaginal delivery not achieved within 24 hours Vaginal PGE2 vs intravenous (IV) oxytocin | no estimate extracted | NR | No studies |
Uterine hyperstimulation with fetal heart rate changes Vaginal PGE2 vs intravenous (IV) oxytocin | no estimate extracted | NR | No studies |
Caesarean section Vaginal PGE2 vs intravenous (IV) oxytocin | RR 0.67 [0.22, 2.03] | 1 study · 42 participants | Low Downgraded: imprecision |
Serious neonatal morbidity/perinatal death Vaginal PGE2 vs intravenous (IV) oxytocin | RR 3 [0.13, 69.7] | 1 study · 42 participants | Low Downgraded: imprecision |
Serious maternal morbidity or death Vaginal PGE2 vs intravenous (IV) oxytocin | RR 3 [0.13, 69.7] | 1 study · 42 participants | Low Downgraded: imprecision |
Vaginal misoprostol versus intravenous (IV) oxytocin
Population: women with a previous caesarean section
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Vaginal delivery not achieved within 24 hours Vaginal misoprostol vs intravenous (IV) oxytocin | no estimate extracted | NR | No studies |
Uterine hyperstimulation with fetal heart rate changes Vaginal misoprostol vs intravenous (IV) oxytocin | no estimate extracted | NR | No studies |
Caesarean section Vaginal misoprostol vs intravenous (IV) oxytocin | no estimate extracted | NR | No studies |
Serious neonatal morbidity or perinatal death Vaginal misoprostol vs intravenous (IV) oxytocin | no estimate extracted | NR | No studies |
Serious maternal morbidity or death Vaginal misoprostol vs intravenous (IV) oxytocin | no estimate extracted | NR | No studies |
Foley catheter versus intravenous (IV) oxytocin
Population: pregnant women with a previous low transverse caesarean section, singleton live pregnancy with cephalic presentation, period of gestation > 28 weeks and BS < 5 were included in the study, with unfavourable cervix
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Vaginal delivery not achieved within 24 hours Foley catheter vs intravenous (IV) oxytocin | RR 1.47 [0.89, 2.44] | 1 study · 53 participants | Low Downgraded: imprecision |
Uterine hyperstimulation with fetal heart rate changes Foley catheter vs intravenous (IV) oxytocin | RR 3.11 [0.13, 73.09] | 1 study · 53 participants | Low Downgraded: imprecision |
Caesarean section Foley catheter vs intravenous (IV) oxytocin | RR 0.93 [0.45, 1.92] | 1 study · 53 participants | Low Downgraded: imprecision |
Serious neonatal morbidity or perinatal death Foley catheter vs intravenous (IV) oxytocin | no estimate extracted | NR | No studies |
Serious maternal morbidity or death Foley catheter vs intravenous (IV) oxytocin | no estimate extracted | NR | No studies |
Double‐balloon catheter versus vaginal PGE2
Population: women with a previous caesarean section (subgroup of all women in the study) with intact fetal membranes, cephalic position and unfavourable cervix, with indications for induction of labour
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Vaginal delivery not achieved within 24 hours Double‐balloon catheter vs vaginal PGE2 | no estimate extracted | NR | No studies |
Uterine hyperstimulation with fetal heart rate changes Double‐balloon catheter vs vaginal PGE2 | no estimate extracted | NR | No studies |
Caesarean section Double‐balloon catheter vs vaginal PGE2 | RR 0.97 [0.41, 2.32] | 1 study · 16 participants | Very low Downgraded: risk of bias, imprecision |
Serious neonatal morbidity or perinatal death Double‐balloon catheter vs vaginal PGE2 | no estimate extracted | NR | No studies |
Serious maternal morbidity or death Double‐balloon catheter vs vaginal PGE2 | no estimate extracted | NR | No studies |
Oral mifepristone versus Foley catheter
Population: pregnant women, 40 weeks' gestation, single cephalic presentation, 1 previous low segment caesarean section
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Vaginal delivery not achieved within 24 hours Oral mifepristone vs Foley catheter | no estimate extracted | NR | No studies |
Uterine hyperstimulation with fetal heart rate changes Oral mifepristone vs Foley catheter | no estimate extracted | NR | No studies |
Caesarean section Oral mifepristone vs Foley catheter | no estimate extracted | NR | No studies |
Serious neonatal morbidity or perinatal death Oral mifepristone vs Foley catheter | no estimate extracted | NR | No studies |
Serious maternal morbidity or death Oral mifepristone vs Foley catheter | no estimate extracted | NR | No studies |
Vaginal isosorbide mononitrate versus Foley catheter
Population: pregnant women with 1 previous lower segment caesarean section at 37 weeks and beyond, with a BS of ≤ 6, intact membranes, reactive non‐stress test, normal umbilical arterial Doppler indices, absence of labour and willingness of women to participate in the study
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Vaginal delivery not achieved within 24 hours Vaginal isosorbide mononitrate vs Foley catheter | RR 2.63 [1.32, 5.21] | 1 study · 80 participants | Low Downgraded: risk of bias, imprecision |
Uterine hyperstimulation with fetal heart rate changes Vaginal isosorbide mononitrate vs Foley catheter | no estimate extracted | NR | No studies |
Caesarean section Vaginal isosorbide mononitrate vs Foley catheter | RR 1 [0.39, 2.59] | 1 study · 80 participants | Very low Downgraded: risk of bias, imprecision |
Serious neonatal morbidity or perinatal death Vaginal isosorbide mononitrate vs Foley catheter | no estimate extracted | NR | No studies |
Serious maternal morbidity or death Vaginal isosorbide mononitrate vs Foley catheter | no estimate extracted | NR | No studies |
80 mL versus 30 mL Foley catheter
Population: pregnant women who previously had a lower segment CS and now have a singleton cephalic presentation after at least 36 completed weeks, not in labour, with intact membranes and BS of < 6
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Vaginal delivery not achieved within 24 hours 80 mL vs 30 mL Foley catheter | RR 1.05 [0.91, 1.2] | 1 study · 154 participants | Moderate Downgraded: imprecision |
Uterine hyperstimulation with fetal heart rate changes 80 mL vs 30 mL Foley catheter | no estimate extracted | NR | No studies |
Caesarean section 80 mL vs 30 mL Foley catheter | RR 1.05 [0.89, 1.24] | 1 study · 154 participants | Moderate Downgraded: imprecision |
Serious neonatal morbidity or perinatal death 80 mL vs 30 mL Foley catheter | no estimate extracted | NR | No studies |
Serious maternal morbidity or death 80 mL vs 30 mL Foley catheter | no estimate extracted | NR | No studies |
Vaginal PGE2 pessary versus vaginal PGE2 tablet
Population: women with a previous caesarean section, a live singleton fetus (37‐42 weeks of gestation) in cephalic presentation and a reactive non‐stress test, BS of ≤ 7 before onset of labour, no spontaneous contractions (< 4 contractions within 20 minutes)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Vaginal delivery not achieved within 24 hours Vaginal PGE2 pessary vs vaginal PGE2 tablet | no estimate extracted | NR | No studies |
Uterine hyperstimulation with fetal heart rate changes Vaginal PGE2 pessary vs vaginal PGE2 tablet | no estimate extracted | NR | No studies |
Caesarean section Vaginal PGE2 pessary vs vaginal PGE2 tablet | RR 1.09 [0.74, 1.6] | 1 study · 200 participants | Very low Downgraded: risk of bias, imprecision |
Serious neonatal morbidity or perinatal death Vaginal PGE2 pessary vs vaginal PGE2 tablet | no estimate extracted | NR | No studies |
Serious maternal morbidity or death Vaginal PGE2 pessary vs vaginal PGE2 tablet | no estimate extracted | NR | No studies |