{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T21:11:05Z","timestamp":1793394665193,"version":"4.5.0"},"reference-count":26,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2015,11,5]],"date-time":"2015-11-05T00:00:00Z","timestamp":1446681600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2016,2]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Various methods are used for cervical ripening during the induction of labour. It is still debatable which of these methods of treatment is optimal.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To compare treatment techniques for cervical ripening in the induction of labour.<\/jats:p><\/jats:sec><jats:sec><jats:title>Search strategy<\/jats:title><jats:p>Medline, Embase, and the Cochrane Collaboration databases were searched using the keywords \u2018cervical ripening\u2019, \u2018labour induced\u2019, \u2018misoprostol\u2019, \u2018dinoprostone\u2019, and \u2018Foley catheter\u2019.<\/jats:p><\/jats:sec><jats:sec><jats:title>Selection criteria<\/jats:title><jats:p>Randomised controlled trials (RCTs) of cervical ripening during the induction of labour, evaluating rates of failure to achieve vaginal delivery within 24 hours, incidence of uterine hyperstimulation with fetal heart rate (FHR) changes, and rates of caesarean section. Studies including women with prelabour rupture of membranes were excluded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data collection and analysis<\/jats:title><jats:p>Outcome data were collected and analysed through pairwise meta\u2010analysis and network meta\u2010analysis within a Bayesian framework.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main results<\/jats:title><jats:p>A total of 96 RCTs (17 387 women) were included in the meta\u2010analysis. Vaginal misoprostol was the most effective cervical ripening method to achieve vaginal delivery within 24 hours, but had the highest incidence of uterine hyperstimulation with FHR changes. The use of a Foley catheter to induce labour was associated with the lowest rate of uterine hyperstimulation accompanied by FHR changes. The caesarean section rate was lowest using oral misoprostol for the induction of labour.<\/jats:p><\/jats:sec><jats:sec><jats:title>Author's conclusions<\/jats:title><jats:p>No method of labour induction demonstrated overall superiority when considering all three clinical outcomes. Decisions regarding the choice of induction method will depend upon the relative preference for effecting vaginal delivery within 24 hours, minimising the incidence of uterine hyperstimulation with adverse FHR changes and avoiding caesarean section.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>Oral misoprostol for the induction of labour is safer than vaginal misoprostol and has the lowest rate of caesarean section.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.13456","type":"journal-article","created":{"date-parts":[[2015,11,5]],"date-time":"2015-11-05T08:56:53Z","timestamp":1446713813000},"page":"346-354","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":179,"title":["A systematic review and network meta\u2010analysis comparing the use of Foley catheters, misoprostol, and dinoprostone for cervical ripening in the induction of labour"],"prefix":"10.1111","volume":"123","author":[{"given":"W","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Nephropathy Xiangya Hospital Central South University Changsha Hunan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Xue","sequence":"additional","affiliation":[{"name":"Department of Medical Records Information Xiangya Hospital Central South University Changsha Hunan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MK","family":"Peprah","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Community Medicine University of Ottawa Ottawa ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"SW","family":"Wen","sequence":"additional","affiliation":[{"name":"OMNI Research Group Department of Obstetrics and Gynecology University of Ottawa Ottawa ON Canada"},{"name":"Ottawa Hospital Research Institute Clinical Epidemiology Program Ottawa ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Walker","sequence":"additional","affiliation":[{"name":"OMNI Research Group Department of Obstetrics and Gynecology University of Ottawa Ottawa ON Canada"},{"name":"Ottawa Hospital Research Institute Clinical Epidemiology Program Ottawa ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Southern Medical University Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Urology The Third Xiangya Hospital of Central South University Changsha Hunan China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,11,5]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1521-6934(03)00037-3"},{"key":"e_1_2_11_3_1","first-page":"21","article-title":"Role of the cervix in the induction of labor","volume":"59","author":"Jagani N","year":"1982","journal-title":"Obstet Gynecol"},{"key":"e_1_2_11_4_1","first-page":"1","article-title":"Recent declines in induction of labor by gestational age","volume":"155","author":"Osterman MJK","year":"2014","journal-title":"NCHS Data Brief"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(97)00259-7"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1967.tb03931.x"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/GCO.0000000000000027"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmwh.2009.03.006"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(96)00374-2"},{"key":"e_1_2_11_10_1","first-page":"159","article-title":"Uses of misoprostol in obstetrics and gynecology","volume":"2","author":"Allen R","year":"2009","journal-title":"Rev Obstet Gynecol"},{"issue":"4","key":"e_1_2_11_11_1","first-page":"Cd004221","article-title":"Buccal or sublingual misoprostol for cervical ripening and induction of labour","author":"Muzonzini G","year":"2004","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2004.06.014"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.331.7521.897"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1875"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/0962280207080643"},{"key":"e_1_2_11_16_1","unstructured":"HigginsJPT GreenS editors.Cochrane Handbook for Systematic Reviews of InterventionsVersion 5.1.0 [updated March 2011].The Cochrane Collaboration 2011. 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