SynthesisThe Cochrane database of systematic reviews2000
Vaginal misoprostol for cervical ripening and labour induction in late pregnancy.
Synthesis in The Cochrane database of systematic reviews, 2000. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 16 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed, 16 syntheses or guidelines pooled it, 216 citations in OpenAlex.
- Castor oil, bath and/or enema for cervical priming and induction of labour.The Cochrane database of systematic reviews · 2013Pooled it
- Vaginal misoprostol for cervical ripening and induction of labour.The Cochrane database of systematic reviews · 2010Pooled it
- Different methods for the induction of labour in outpatient settings.The Cochrane database of systematic reviews · 2010Pooled it
- Intravenous oxytocin alone for cervical ripening and induction of labour.The Cochrane database of systematic reviews · 2009Pooled it
- Misoprostol to prevent and treat postpartum haemorrhage: a systematic review and meta-analysis of maternal deaths and dose-related effects.Bulletin of the World Health Organization · 2009Pooled it
- Outpatient versus inpatient induction of labour for improving birth outcomes.The Cochrane database of systematic reviews · 2009Pooled it
- Hyaluronidase for cervical ripening and induction of labour.The Cochrane database of systematic reviews · 2006Pooled it
- Membrane sweeping for induction of labour.The Cochrane database of systematic reviews · 2005Pooled it
- Buccal or sublingual misoprostol for cervical ripening and induction of labour.The Cochrane database of systematic reviews · 2004Pooled it
- Extra-amniotic prostaglandin for induction of labour.The Cochrane database of systematic reviews · 2001Pooled it
- Sexual intercourse for cervical ripening and induction of labour.The Cochrane database of systematic reviews · 2001Pooled it
- Oral prostaglandin E2 for induction of labour.The Cochrane database of systematic reviews · 2001Pooled it
- Relaxin for cervical ripening and induction of labour.The Cochrane database of systematic reviews · 2001Pooled it
- Oestrogens alone or with amniotomy for cervical ripening or induction of labour.The Cochrane database of systematic reviews · 2001Pooled it
- Amniotomy alone for induction of labour.The Cochrane database of systematic reviews · 2000Pooled it
- Intravenous prostaglandin for induction of labour.The Cochrane database of systematic reviews · 2000Pooled it
- Influence of nursing interventions in improving midwives' knowledge of misoprostol use in the management of postpartum haemorrhage at selected hospitals in Ondo State, Nigeria.The Pan African medical journal · 2021Trial
- Oral misoprostol for induction of labour at term: randomised controlled trial.BMJ (Clinical research ed.) · 2006Trial
- Comparison of misoprostol and dinoprostone for elective induction of labour in nulliparous women at full term: a randomized prospective study.Reproductive biology and endocrinology : RB&E · 2004Trial
- Misoprostol versus oxytocin for labor induction in term and post-term pregnancy: randomized controlled trial.Sao Paulo medical journal = Revista paulista de medicina · 2003Trial
Corrections and comments
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Authors and funding
2 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAlthough not yet registered for such use, misoprostol has been widely used for obstetric and gynaecological indications, such as induction of abortion and of labour.
objectivesThe objective of this review was to assess the effects of vaginal misoprostol for third trimester cervical ripening or induction of labour. SEARCH STRATEGY: The Cochrane Pregnancy and Childbirth Group trials register, the Cochrane Controlled Trials Register and reference lists of articles were searched. SELECTION CRITERIA: Randomised trials comparing vaginal misoprostol with other methods of cervical ripening or labour induction, placebo or no treatment in women due for third trimester induction of labour. DATA COLLECTION AND ANALYSIS: Trial quality assessment and data extraction were done by both reviewers. MAIN
resultsTwenty-six studies were included. Compared to placebo, misoprostol was associated with increased cervical ripening (relative risk of unfavourable or unchanged cervix after 12 to 24 hours with misoprostol 0.20, 95% confidence interval 0.07 to 0.61). It was also associated with a reduced need for oxytocin (relative risk 0.47, 95% confidence interval 0.23 to 0.96). Misoprostol was more effective than prostaglandin E2 for labour induction (relative risk of failure to achieve vaginal delivery in 24 hours 0.70, 95% confidence interval 0.62 to 0.79). Oxytocin augmentation was used less often with misoprostol than with prostaglandin E2 (relative risk 0.64, 95% confidence interval 0.58 to 0.71). Uterine hyperstimulation and meconium stained liquor were more common with misoprostol than with prostaglandin E2. Lower doses of misoprostol compared to higher doses did not show significant differences except for more need for oxytocin augmentation and less uterine hyperstimulation without fetal heart rate changes. REVIEWER'S
conclusionsVaginal misoprostol appears to be more effective in inducing labour than conventional methods of cervical ripening and labour induction. The apparent increase in uterine hyperstimulation is of concern. The studies were not large enough to exclude the possibility of rare but serious adverse effects.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.