Evidence map›Paper›PMID 40221656›Full record

SynthesisBMC pregnancy and childbirth2025

Inducing labor after fetal demise: a systematic review and meta-analysis of the efficacy and safety of mifepristone and misoprostol combination versus misoprostol alone.

Maryam Shami, Mona Larki, Somayeh Makvandi, Mahnaz Azari

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in BMC pregnancy and childbirth, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Maryam ShamiStudent Research Committee, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Mona LarkiNursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Somayeh MakvandiMenopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Somayemakvandi@gmail.com.
Mahnaz AzariStudent Research Committee, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. mahnazazari244@gmail.com.

Funding

Ahvaz Jundishapur University of Medical Sciences, Iran, Islamic Republic Of IR.AJUMS.REC.1403.172
6 · The paper itself

Abstract

introductionIntrauterine fetal demise (IUFD), one of the most tragic outcomes of pregnancy, affects approximately 1% of pregnancies. This systematic review aims to assess the efficacy and safety of mifepristone combined with misoprostol versus misoprostol alone in inducing labor in women with IUFD.

methodsWe conducted a comprehensive literature search of scientific databases from their inception up to July 29, 2024. Randomized controlled trials (RCTs) comparing the Efficacy and Safety of mifepristone and misoprostol with misoprostol alone in women with IUFD were included. The quality of the included RCTs was assessed using the Cochrane risk of bias tool (RoB). All analyses were performed using RevMan version 5.4. To determine the quality of evidence, we used the GRADE tool.

resultsTen RCTs were included in the qualitative and quantitative synthesis. The analysis revealed a significant reduction in the induction delivery interval with the combination treatment, with a total mean difference of - 7.86 h (MD = - 7.86, 95% CI: - 9.98 to - 5.73, p < 0.00001), favoring mifepristone plus misoprostol. There was a significant reduction in the number of misoprostol doses needed (MD = - 1.38, 95% CI: - 1.82 to - 0.94, p < 0.00001) and in the total misoprostol dose (MD = - 60.51, 95% CI: - 106.98 to - 14.04, p = 0.01), favoring the use of mifepristone plus misoprostol. The quality of evidence ranged from low to moderate.

conclusionOur study provides compelling evidence that the combination therapy of mifepristone and misoprostol results in a significant reduction in the induction delivery interval and total dosage of misoprostol required for successful labor induction compared to misoprostol administered alone. Further high-quality research is essential to confirm these results.

Indexed as

Labor, InducedMifepristoneMisoprostolDrug Therapy, CombinationFemaleFetal DeathHumansPregnancyRandomized Controlled Trials as TopicMifepristoneMisoprostolFetal DemiseLabor InductionMifepristoneMisoprostolStillbirth

Identifiers

PMID40221656
PMCPMC11992822

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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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.