{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T11:34:41Z","timestamp":1787916881553,"version":"build-2784847793"},"reference-count":61,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T00:00:00Z","timestamp":1784851200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T00:00:00Z","timestamp":1784851200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Pharmacologic cervical ripening is frequently used for labor induction, yet the comparative effectiveness, safety, and resource utilization of available agents remain uncertain. This review compared oral misoprostol with vaginal dinoprostone for labor induction in singleton pregnancies at \u2265\u200934\u2009weeks' gestation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a systematic review and meta\u2010analysis of randomized controlled trials, searching 11 databases to May 2025. Eligible studies compared oral misoprostol with vaginal dinoprostone in singleton pregnancies \u2265\u200934\u2009weeks undergoing induction without contraindications to vaginal birth. Seven critical outcomes were assessed: cesarean birth, uterine hyperstimulation, 5\u2010min Apgar score &lt;\u20097, neonatal intensive care unit (NICU) admission, oxytocin augmentation, vaginal birth within 24\u2009h, and induction\u2010to\u2010birth interval. Study selection and data extraction were performed in duplicate. Random\u2010effects meta\u2010analysis was applied, with risk of bias, certainty of evidence, and subgroup credibility assessed using Cochrane RoB 2.0, GRADE, and ICEMAN.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Eleven trials including 3783 participants were analyzed. Oral misoprostol was associated with lower cesarean birth (RR 0.83, 95% CI 0.74\u20130.94) and reduced oxytocin augmentation (RR 0.89, 95% CI 0.82\u20130.97). Vaginal dinoprostone was associated with higher vaginal birth within 24\u2009h (RR 0.91, 95% CI 0.86\u20130.96) and a shorter induction\u2010to\u2010birth interval. No significant differences were observed in uterine hyperstimulation, 5\u2010min Apgar score &lt;\u20097, or NICU admission.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Oral misoprostol is associated with reduced cesarean birth and probably reduces the need for oxytocin augmentation, while vaginal dinoprostone is associated with higher rates of vaginal birth within 24\u2009h and probably a shorter induction\u2010to\u2010birth interval. Maternal and neonatal safety outcomes appear comparable; these findings support consideration of oral misoprostol in selected populations and settings, while acknowledging underlying clinical and methodological heterogeneity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jog.70369","type":"journal-article","created":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T05:42:51Z","timestamp":1784958171000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Oral Misoprostol Versus Vaginal Dinoprostone for Labor Induction: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-7026-0479","authenticated-orcid":false,"given":"Tiffany","family":"Yeretsian","sequence":"first","affiliation":[{"name":"Department of Obstetrics &amp; Gynecology McMaster University  Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hussain","family":"Mogharbel","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine, Department of Obstetrics &amp; Gynaecology, Mount Sinai Hospital University of Toronto  Toronto Ontario Canada"},{"name":"Department of Obstetrics &amp; Gynaecology King Abdulaziz University  Jeddah Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rayyan","family":"Rozzah","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynaecology King Abdulaziz University  Jeddah Saudi Arabia"},{"name":"Division of Gynecologic Oncology, Department of Obstetrics &amp; Gynaecology McGill University Health Center  Montreal Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5287-0273","authenticated-orcid":false,"given":"Rizwana","family":"Ashraf","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynecology McMaster University  Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abirami","family":"Kirubarajan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynecology McMaster University  Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristian","family":"Thorlund","sequence":"additional","affiliation":[{"name":"Department of Health Research Methods, Evidence and Impact McMaster University  Hamilton Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4049-2017","authenticated-orcid":false,"given":"Rohan","family":"D'Souza","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynecology McMaster University  Hamilton Ontario Canada"},{"name":"Department of Health Research Methods, Evidence and Impact McMaster University  Hamilton Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,24]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0228196"},{"key":"e_1_2_12_3_1","volume-title":"WHO Recommendations: Induction of Labour at or Beyond Term","author":"World Health Organization","year":"2018"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD014484"},{"key":"e_1_2_12_5_1","volume-title":"Inducing Labour","author":"NICE","year":"2012"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884\u2010017\u20101483\u20105"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.13456"},{"issue":"10","key":"e_1_2_12_8_1","first-page":"CD000941","article-title":"Vaginal Misoprostol for Cervical Ripening and Induction of Labour","volume":"2010","author":"Hofmeyr G. 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