{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T15:50:22Z","timestamp":1790178622465,"version":"4.1.0"},"reference-count":63,"publisher":"Wiley","issue":"13","license":[{"start":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T00:00:00Z","timestamp":1749600000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["GNT1176437"],"award-info":[{"award-number":["GNT1176437"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["GNT2016729"],"award-info":[{"award-number":["GNT2016729"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["GNT2025670"],"award-info":[{"award-number":["GNT2025670"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100015539","name":"Australian Government","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100015539","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The optimal methods and settings for induction of labour (IOL) in terms of effectiveness, safety, and women's experience are still not elucidated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare the effectiveness and safety of outpatient versus inpatient cervical ripening settings for IOL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Search Strategy<\/jats:title>\n                    <jats:p>\n                      MEDLINE, Embase, Emcare, CINAHL Plus, Scopus, Cochrane Library, WHO ICTRP and\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">clinicaltrials.gov<\/jats:ext-link>\n                      from inception to July 2024.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Selection Criteria<\/jats:title>\n                    <jats:p>Randomised controlled trials, viable singleton gestation, no language restrictions, all the published and unpublished data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Collection and Analysis<\/jats:title>\n                    <jats:p>An individual participant data meta\u2010analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Results<\/jats:title>\n                    <jats:p>Eleven out of 18 (61.1%) eligible RCTs shared IPD, totalling 2593 pregnant individuals undergoing IOL (62.2% of all participants in the published RCTs). Among the shared RCTs, four used balloon catheters alone in both groups. Three RCTs compared outpatient balloon catheter with inpatient balloon catheter plus oxytocin. Another three RCTs compared outpatient balloon catheter to inpatient vaginal dinoprostone. One RCT used Dilapan\u2010S in both groups. No trials evaluating outpatient use of vaginal prostaglandins were identified. Vaginal birth (11 RCTs, 2584 women, 67.8% vs. 70.2%, aOR 0.95, 95% CI 0.70; 1.30), composite perinatal outcome (9 RCTs, 2525 women, 11.1% vs. 11.7%, aOR 0.93, 95% CI 0.75; 1.16) and composite maternal (10 RCTs, 2480 women, 14.3% vs. 15.4%, aOR 0.89, 95% CI 0.65; 1.20) outcome did not differ between outpatient and inpatient groups. The outpatient group had a lower risk of acidosis, more epidural analgesia, and more oxytocin. There were no perinatal deaths in either group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Overall effectiveness, perinatal and maternal safety are comparable between outpatient setting cervical ripening with a mechanical method and inpatient with any method.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>PROSPERO: CRD42022313183<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1471-0528.18253","type":"journal-article","created":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T05:30:28Z","timestamp":1749619828000},"page":"1966-1982","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Outpatient or Inpatient Setting for Cervical Ripening Before Induction of Labour: An Individual Participant Data Meta\u2010Analysis"],"prefix":"10.1111","volume":"132","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4092-7092","authenticated-orcid":false,"given":"Malitha","family":"Patabendige","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology Monash University  Melbourne Australia"},{"name":"Monash Women's Monash Health  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0870-661X","authenticated-orcid":false,"given":"Fei","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Monash University  Melbourne Australia"},{"name":"Monash Women's Monash Health  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9194-9585","authenticated-orcid":false,"given":"Michelle R.","family":"Wise","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynaecology and Reproductive Sciences, Faculty of Medical and Health Sciences The University of Auckland  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John M. D.","family":"Thompson","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynaecology and Reproductive Sciences, Faculty of Medical and Health Sciences The University of Auckland  Auckland New Zealand"},{"name":"Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences The University of Auckland  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7319-6938","authenticated-orcid":false,"given":"Michael","family":"Beckmann","sequence":"additional","affiliation":[{"name":"Mater Health and Mater Research The University of Queensland  Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0034-3567","authenticated-orcid":false,"given":"Antonio F.","family":"Saad","sequence":"additional","affiliation":[{"name":"Perinatal Research Unit Inova Health Fairfax  Falls Church Virginia USA"},{"name":"Division of Maternal\u2010Fetal Medicine University of Texas Medical Branch  Galveston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George R.","family":"Saade","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine University of Texas Medical Branch  Galveston Texas USA"},{"name":"Department of Obstetrics and Gynecology Eastern Virginia Medical School  Norfolk Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akila","family":"Subramaniam","sequence":"additional","affiliation":[{"name":"Center for Women's Reproductive Health and Department of Obstetrics and Gynecology University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7244-9056","authenticated-orcid":false,"given":"Alan","family":"Tita","sequence":"additional","affiliation":[{"name":"Center for Women's Reproductive Health and Department of Obstetrics and Gynecology University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catarina","family":"Policiano","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology and Reproductive Medicine Hospital de Santa Maria, Unidade Local de Sa\u00fade de Santa Maria  Lisboa Portugal"},{"name":"Universitary Clinic of Obstetrics and Gynecology Medical School, University of Lisbon  Lisbon Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nuno","family":"Clode","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology and Reproductive Medicine Hospital de Santa Maria, Unidade Local de Sa\u00fade de Santa Maria  Lisboa Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7351-8922","authenticated-orcid":false,"given":"Amanda","family":"Henry","sequence":"additional","affiliation":[{"name":"Discipline of Women's Health School of Clinical Medicine, UNSW Medicine &amp; 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