“…Lack of consensus likely depends on the heterogeneous characteristics of the control group in terms of parity, gestational age, pre-induction Bishop score, substance and dosage used. In earlier studies, the pessary has been indifferently compared with vaginal or intracervical gel containing prostaglandin E 2 , and with misoprostol, a strong analog which has multiple indications [9][10][11][12][13][14][15][16][17]; more recently equal effectiveness has been reported for both procedures [18,19].…”