Cervical ripening: The comparative effectiveness of Lamice and prostaglandin E2 tablets

Cahill, Declan; Clark, H. S. G.; Martin, D. H.

doi:10.1007/bf02950366

Cited by 5 publications

(4 citation statements)

References 10 publications

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“…anticipated end date 2013 => no information could be obtained (authors were contacted)Ben‐Aroya 2001There is no mention of randomisation in the abstract. Retrospective cohort study.Buccellato 2000High‐dose misoprostolCahill 1988Alternate randomisation.Caughey 2007Balloon high vs low volume => not within scope of reviewChipato 19972 regimens of extra‐amniotic infusion compared.Chung 2003High‐dose misoprostolConnolly 2016Foley+ oxytocin vs Foley => not within scope of reviewConnolly 2017Foley + oxytocin vs Foley (multiparae) => not within scope of reviewCross 1978Randomisation based on the last digit of the hospital chart number. 6 women were excluded in the laminaria group, and 1 in the control group.…”

Section: Characteristics Of Excluded Studies [Ordered By Study Id]mentioning

confidence: 99%

Mechanical methods for induction of labour

Vaan

Eikelder

Jozwiak

et al. 2019

Cochrane Database of Systematic Reviews

101

117

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BackgroundMechanical methods were the first methods developed to ripen the cervix and induce labour. During recent decades they have been substituted by pharmacological methods. Potential advantages of mechanical methods, compared with pharmacological methods may include reduction in side effects that could improve neonatal outcomes. This is an update of a review first published in 2001, last updated in 2012.ObjectivesTo determine the effectiveness and safety of mechanical methods for third trimester (> 24 weeks' gestation) induction of labour in comparison with prostaglandin E2 (PGE2) (vaginal and intracervical), low‐dose misoprostol (oral and vaginal), amniotomy or oxytocin.Search methodsFor this update, we searched Cochrane Pregnancy and Childbirth’s Trials Register, , the WHO International Clinical Trials Registry Platform (), and reference lists of retrieved studies (9 January 2018). We updated the search in March 2019 and added the search results to the awaiting classification section of the review.Selection criteriaClinical trials comparing mechanical methods used for third trimester cervical ripening or labour induction with pharmacological methods.Mechanical methods include: (1) the introduction of a catheter through the cervix into the extra‐amniotic space with balloon insufflation; (2) introduction of laminaria tents, or their synthetic equivalent (Dilapan), into the cervical canal; (3) use of a catheter to inject fluid into the extra‐amniotic space (EASI).This review includes the following comparisons: (1) specific mechanical methods (balloon catheter, laminaria tents or EASI) compared with prostaglandins (different types, different routes) or with oxytocin; (2) single balloon compared to a double balloon; (3) addition of prostaglandins or oxytocin to mechanical methods compared with prostaglandins or oxytocin alone.Data collection and analysisTwo review authors independently assessed trials for inclusion and assessed risk of bias. Two review authors independently extracted data and assessed the quality of the evidence using the GRADE approach.Main resultsThis review update includes a total of 113 trials (22,373 women) contributing data to 21 comparisons. Risk of bias of trials varied. Overall, the evidence was graded from very‐low to moderate quality. All evidence was downgraded for lack of blinding and, for many comparisons, the effect estimates were too imprecise to make a valid judgement.Balloon versus vaginal PGE2: there may be little or no difference in vaginal deliveries not achieved within 24 hours (average risk ratio (RR) 1.01, 95% confidence interval (CI) 0.82 to 1.26; 7 studies; 1685 women; I² = 79%; low‐quality evidence) and there probably is little or no difference in caesarean sections (RR 1.00, 95% CI 0.92 to 1.09; 28 studies; 6619 women; moderate‐quality evidence) between induction of labour with a balloon catheter and vaginal PGE2. A balloon catheter probably reduces the risk of uterine hyperstimulation with fetal heart rate (FHR) changes (RR 0.35, 95% CI 0.18 to 0.67; 6 studies; 1966 ...

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Section: Characteristics Of Excluded Studies [Ordered By Study Id]mentioning

confidence: 99%

Mechanical methods for induction of labour

Vaan

Eikelder

Jozwiak

et al. 2019

Cochrane Database of Systematic Reviews

101

117

View full text Add to dashboard Cite

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“…Overall, 14 studies with 15 arms were included in the final analysis. 12 13 14 15 16 17 18 19 20 21 22 23 24 25 Ten and four studies were RCTs 12 13 14 15 18 19 20 21 22 23 and NCTs, 16 17 18 25 respectively. These studies comprised a total of 2,380 patients, of which 1,170 and 1,210 patients were allocated to the cervical osmotic dilator and dinoprostone groups, respectively.…”

Section: Resultsmentioning

confidence: 99%

“…S1 (available in the online version) shows the summary of the risk of bias of the included RCTs. 12 13 14 15 18 19 20 21 22 23 In consideration of the open-label nature of the interventions, blinding was not feasible; accordingly, the corresponding domains for performance bias and detection bias were scored as high risk. Several RCTs did not provide sufficient information about random sequence generation and allocation concealment; accordingly, the corresponding domains for selection bias were scored as unclear risk.…”

Section: Resultsmentioning

confidence: 99%

“…11 Several research investigations have surveyed the clinical utility of cervical osmotic dilators versus dinoprostone for preinduction cervical ripening during labor induction. [12][13][14][15][16][17][18][19][20][21][22][23][24][25] However, the different study designs, small number of sampled patients, and conflicting findings are some of the key limitations of these investigations. In addition, to our knowledge, there is no report-yet-that has thoroughly condensed the evidence on the subject.…”

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confidence: 99%

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Cervical Osmotic Dilators versus Dinoprostone for Cervical Ripening during Labor Induction: A Systematic Review and Meta-analysis of 14 Controlled Trials

et al. 2023

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Objective This study aimed to conduct a systematic review and meta-analysis of all randomized and nonrandomized controlled trials (RCTs and NCTs, respectively) that explored the maternal–neonatal outcomes of cervical osmotic dilators versus dinoprostone in promoting cervical ripening during labor induction. Study Design Six major databases were screened until August 27, 2022. The quality of included studies was evaluated. The data were summarized as mean difference or risk ratio (RR) with 95% confidence interval (CI) in a random-effects model. Results Overall, 14 studies with 15 arms were analyzed (n = 2,380 patients). Ten and four studies were RCTs and NCTs, respectively. The overall quality for RCTs varied (low risk n = 2, unclear risk n = 7, and high risk n = 1), whereas all NCTs had good quality (n = 4). For the primary endpoints, there was no significant difference between both groups regarding the rate of normal vaginal delivery (RR = 1.04, 95% CI: 0.95–1.14, p = 0.41) and rate of cesarean delivery (RR = 1.04, 95% CI: 0.93–1.17, p = 0.51). Additionally, there was no significant difference between both groups regarding the mean change in Bishop score and mean time from intervention to delivery. The rate of uterine hyperstimulation was significantly lower in the cervical osmotic dilator group. For the neonatal outcomes, during cervical ripening, the rate of fetal distress was significantly lower in the cervical osmotic dilator group. There was no significant difference between both groups regarding the mean Apgar scores, rate of meconium-stained amniotic fluid, rate of umbilical cord metabolic acidosis, rate of neonatal infection, and rate of neonatal intensive care unit admission. Conclusion During labor induction, cervical ripening with cervical osmotic dilators and dinoprostone had comparable maternal–neonatal outcomes. Cervical osmotic dilators had low risk of uterine hyperstimulation compared with dinoprostone. Overall, cervical osmotic dilators might be more preferred over dinoprostone in view of their analogous cervical ripening effects, comparable maternal–neonatal outcomes, and lack of drug-related adverse events. Key Points

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