Comparison on efficacy and safety of seven different methods for labor induction: a network meta-analysis

• DOI: 10.3760/cma.j.issn.1007-9408.2014.04.005
• Publication Date: 2014-04-16
• Authors: Zengfang Wang; Pingping Wang; Ying Tan; Jiang Kui-jin
• Keywords: Dinoprostone; Apgar score; Foley catheter; Labor Induction

Objective With a network meta-analysis,to compare the effects and safety of seven clinically common-used induction methods.Methods Publications randomized controlled trials between January 1,1980 November 20,2011 were searched on Medline,Embase Cochrane Central Register Controlled Trials with following terms including dinoprostone,misoprostol,Foley catheter,oxytocin labor induction.A meta analysis both direct indirect comparison was applied for 48 (19 819 participants) recruited,and methods in publications compared:oxytocin (intravenous,Ⅳ),vaginal dinoprostone,intracervical dinoprostone,oral misoprostol,vaginal misoprostol,sublingual misoprostol foley catheter.The main outcomes proportion vaginal delivery within 24 hours,cesarean section rate,uterine hyperstimulation rate Apgar score＜7 at 5 min after birth.Medline,Embase 20,2011.Results Foley catheter had lowest cesarean uterine rate.Vaginal method highest number hours,but rate.The neonatal found women using sublingual misoprostol,while those Dinoprostone.Oxytocin (Ⅳ) hours rate.Conclusion is best available option efficacy safety,while effect oxytocin not good enough.Vaginal dinoprostone relative but obvious adverse effects.

Key words: Labor, induced; Meta-analysis; Treatment outcome