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. 2001;2001(2):CD003092.
doi: 10.1002/14651858.CD003092.

Extra-amniotic prostaglandin for induction of labour

E Hutton  1 , E Mozurkewich
Affiliations

Extra-amniotic prostaglandin for induction of labour

E Hutton et al. Cochrane Database Syst Rev. 2001.

Abstract

Background: This is one of a series of reviews of methods of cervical ripening and labour induction using standardised methodology.

Objectives: To determine the effects of extra-amniotic prostaglandin 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 bibliographies of relevant papers. Date of last search: December 2000.

Selection criteria: (1) clinical trials comparing extra-amniotic prostaglandin used for third trimester cervical ripening or labour induction with placebo/no treatment or other methods listed above it on a predefined list of labour induction methods; (2) random allocation to the treatment or control group; (3) adequate allocation concealment; (4) violations of allocated management not sufficient to materially affect conclusions; (5) clinically meaningful outcome measures reported; (6) data available for analysis according to the random allocation; (7) missing data insufficient to materially affect the conclusions.

Data collection and analysis: A strategy has been developed to deal with the large volume and complexity of trial data relating to labour induction. This has involved a two-stage method of data extraction. The initial data were extracted centrally, and incorporated into a series of primary reviews arranged by methods of induction of labour, following a standardised methodology.

Main results: Oxytocin was used to initiate or augment labour significantly less frequently with extra-amniotic prostaglandins when compared to placebo (relative risk 0.50, 95% confidence interval 0.38-0.66). No other findings were significant in the comparisons that were made for this review including when extra-amniotic prostaglandins were compared with other methods of cervical ripening or induction of labour. Although this could suggest that extra-amniotic prostaglandins are as effective as other agents, the findings are difficult to interpret because they are based on very small numbers and may lack the power to show a real difference.

Reviewer's conclusions: The studies in this review are limited by their small sample sizes which are in many cases further divided into multiple comparison groups. The analyses resulted in most comparisons showing no significant differences, with wide confidence intervals. Although extra-amniotic prostaglandins may be as effective as other modalities in initiating labour, there is little conclusive information from this review to guide clinical practice. An adequately powered randomised controlled trial would be useful to determine if the use of extra-amniotic prostaglandins would lower the rate of caesarean section. However, in the time since these studies were undertaken the use of extra-amniotic prostaglandins has largely been replaced by other modes of prostaglandin administration.

PubMed Disclaimer

Conflict of interest statement

None known.

Figures

1.1
1.1. Analysis
Comparison 1 Extra‐amniotic PGE2 vs extra‐amniotic placebo: all women, Outcome 1 Apgar score < 7 at 5 minutes.
1.2
1.2. Analysis
Comparison 1 Extra‐amniotic PGE2 vs extra‐amniotic placebo: all women, Outcome 2 Uterine hyperstimulation with FHR changes.
1.3
1.3. Analysis
Comparison 1 Extra‐amniotic PGE2 vs extra‐amniotic placebo: all women, Outcome 3 Caesarean section.
1.4
1.4. Analysis
Comparison 1 Extra‐amniotic PGE2 vs extra‐amniotic placebo: all women, Outcome 4 Abnormal FHR.
1.5
1.5. Analysis
Comparison 1 Extra‐amniotic PGE2 vs extra‐amniotic placebo: all women, Outcome 5 Dystocia.
1.6
1.6. Analysis
Comparison 1 Extra‐amniotic PGE2 vs extra‐amniotic placebo: all women, Outcome 6 Intrapartum fever.
1.7
1.7. Analysis
Comparison 1 Extra‐amniotic PGE2 vs extra‐amniotic placebo: all women, Outcome 7 Oxytocin augmentation.
1.8
1.8. Analysis
Comparison 1 Extra‐amniotic PGE2 vs extra‐amniotic placebo: all women, Outcome 8 Uterine hyperstimulation without FHR changes.
1.9
1.9. Analysis
Comparison 1 Extra‐amniotic PGE2 vs extra‐amniotic placebo: all women, Outcome 9 Postpartum haemorrhage.
1.10
1.10. Analysis
Comparison 1 Extra‐amniotic PGE2 vs extra‐amniotic placebo: all women, Outcome 10 Instrumental vaginal delivery.
1.11
1.11. Analysis
Comparison 1 Extra‐amniotic PGE2 vs extra‐amniotic placebo: all women, Outcome 11 Maternal side‐effects.
2.1
2.1. Analysis
Comparison 2 Extra‐amniotic PGE2 vs extra‐amniotic placebo: all women, unfavourable cervix, Outcome 1 Uterine hyperstimulation with FHR changes.
2.2
2.2. Analysis
Comparison 2 Extra‐amniotic PGE2 vs extra‐amniotic placebo: all women, unfavourable cervix, Outcome 2 Caesarean section.
2.3
2.3. Analysis
Comparison 2 Extra‐amniotic PGE2 vs extra‐amniotic placebo: all women, unfavourable cervix, Outcome 3 Oxytocin augmentation.
2.4
2.4. Analysis
Comparison 2 Extra‐amniotic PGE2 vs extra‐amniotic placebo: all women, unfavourable cervix, Outcome 4 Uterine hyperstimulation without FHR changes.
2.5
2.5. Analysis
Comparison 2 Extra‐amniotic PGE2 vs extra‐amniotic placebo: all women, unfavourable cervix, Outcome 5 Instrumental vaginal delivery.
2.6
2.6. Analysis
Comparison 2 Extra‐amniotic PGE2 vs extra‐amniotic placebo: all women, unfavourable cervix, Outcome 6 Maternal side‐effects.
3.1
3.1. Analysis
Comparison 3 Extra‐amniotic PGE2 vs extra‐amniotic placebo: all primiparae, Outcome 1 Caesarean section.
3.2
3.2. Analysis
Comparison 3 Extra‐amniotic PGE2 vs extra‐amniotic placebo: all primiparae, Outcome 2 Oxytocin augmentation.
4.1
4.1. Analysis
Comparison 4 Extra‐amniotic PGF2 alpha vs extra‐amniotic placebo gel: all women, Outcome 1 Caesarean section.
4.2
4.2. Analysis
Comparison 4 Extra‐amniotic PGF2 alpha vs extra‐amniotic placebo gel: all women, Outcome 2 Serious maternal morbidity or death.
4.3
4.3. Analysis
Comparison 4 Extra‐amniotic PGF2 alpha vs extra‐amniotic placebo gel: all women, Outcome 3 Uterine hyperstimulation without FHR changes.
4.4
4.4. Analysis
Comparison 4 Extra‐amniotic PGF2 alpha vs extra‐amniotic placebo gel: all women, Outcome 4 Instrumental vaginal delivery.
4.5
4.5. Analysis
Comparison 4 Extra‐amniotic PGF2 alpha vs extra‐amniotic placebo gel: all women, Outcome 5 Perinatal death.
5.1
5.1. Analysis
Comparison 5 Extra‐amniotic PGF2 alpha vs extra‐amniotic placebo gel: all women, unfavourable cervix, Outcome 1 Caesarean section.
5.2
5.2. Analysis
Comparison 5 Extra‐amniotic PGF2 alpha vs extra‐amniotic placebo gel: all women, unfavourable cervix, Outcome 2 Serious maternal morbidity or death.
5.3
5.3. Analysis
Comparison 5 Extra‐amniotic PGF2 alpha vs extra‐amniotic placebo gel: all women, unfavourable cervix, Outcome 3 Uterine hyperstimulation without FHR changes.
5.4
5.4. Analysis
Comparison 5 Extra‐amniotic PGF2 alpha vs extra‐amniotic placebo gel: all women, unfavourable cervix, Outcome 4 Instrumental vaginal delivery.
5.5
5.5. Analysis
Comparison 5 Extra‐amniotic PGF2 alpha vs extra‐amniotic placebo gel: all women, unfavourable cervix, Outcome 5 Perinatal death.
6.1
6.1. Analysis
Comparison 6 Extra‐amniotoc PGF2 alpha vs extra‐amniotic placebo gel: all primiparae, Outcome 1 Caesarean section.
6.2
6.2. Analysis
Comparison 6 Extra‐amniotoc PGF2 alpha vs extra‐amniotic placebo gel: all primiparae, Outcome 2 Serious maternal morbidity or death.
6.3
6.3. Analysis
Comparison 6 Extra‐amniotoc PGF2 alpha vs extra‐amniotic placebo gel: all primiparae, Outcome 3 Uterine hyperstimulation without FHR changes.
6.4
6.4. Analysis
Comparison 6 Extra‐amniotoc PGF2 alpha vs extra‐amniotic placebo gel: all primiparae, Outcome 4 Instrumental vaginal delivery.
6.5
6.5. Analysis
Comparison 6 Extra‐amniotoc PGF2 alpha vs extra‐amniotic placebo gel: all primiparae, Outcome 5 Perinatal death.
7.1
7.1. Analysis
Comparison 7 Extra‐amniotic PGF2 alpha vs placebo gel: all primiparae, unfavourable cervix, Outcome 1 Caesarean section.
7.2
7.2. Analysis
Comparison 7 Extra‐amniotic PGF2 alpha vs placebo gel: all primiparae, unfavourable cervix, Outcome 2 Serious maternal morbidity or death.
7.3
7.3. Analysis
Comparison 7 Extra‐amniotic PGF2 alpha vs placebo gel: all primiparae, unfavourable cervix, Outcome 3 Uterine hyperstimulation without FHR changes.
7.4
7.4. Analysis
Comparison 7 Extra‐amniotic PGF2 alpha vs placebo gel: all primiparae, unfavourable cervix, Outcome 4 Instrumental vaginal delivery.
7.5
7.5. Analysis
Comparison 7 Extra‐amniotic PGF2 alpha vs placebo gel: all primiparae, unfavourable cervix, Outcome 5 Perinatal death.
8.1
8.1. Analysis
Comparison 8 Extra‐amniotic PGE2 vs vaginal PGE2: all women, Outcome 1 Vaginal delivery not achieved within 24 hours.
8.2
8.2. Analysis
Comparison 8 Extra‐amniotic PGE2 vs vaginal PGE2: all women, Outcome 2 Uterine hyperstimulation with FHR changes.
8.3
8.3. Analysis
Comparison 8 Extra‐amniotic PGE2 vs vaginal PGE2: all women, Outcome 3 Caesarean section.
8.4
8.4. Analysis
Comparison 8 Extra‐amniotic PGE2 vs vaginal PGE2: all women, Outcome 4 Maternal satisfaction.
8.5
8.5. Analysis
Comparison 8 Extra‐amniotic PGE2 vs vaginal PGE2: all women, Outcome 5 Oxytocin augmentation.
8.6
8.6. Analysis
Comparison 8 Extra‐amniotic PGE2 vs vaginal PGE2: all women, Outcome 6 Uterine hyperstimulation without FHR changes.
8.7
8.7. Analysis
Comparison 8 Extra‐amniotic PGE2 vs vaginal PGE2: all women, Outcome 7 Instrumental vaginal delivery.
8.8
8.8. Analysis
Comparison 8 Extra‐amniotic PGE2 vs vaginal PGE2: all women, Outcome 8 Meconium‐stained liquor.
8.9
8.9. Analysis
Comparison 8 Extra‐amniotic PGE2 vs vaginal PGE2: all women, Outcome 9 Apgar score < 7 at 5 minutes.
8.10
8.10. Analysis
Comparison 8 Extra‐amniotic PGE2 vs vaginal PGE2: all women, Outcome 10 Maternal side‐effects.
8.11
8.11. Analysis
Comparison 8 Extra‐amniotic PGE2 vs vaginal PGE2: all women, Outcome 11 Maternal satisfaction ‐ embarassment.
9.1
9.1. Analysis
Comparison 9 Extra‐amniotic PGE2 vs vaginal PGE2: all women, unfavourable cervix, Outcome 1 Vaginal delivery not achieved in 24 hours.
9.2
9.2. Analysis
Comparison 9 Extra‐amniotic PGE2 vs vaginal PGE2: all women, unfavourable cervix, Outcome 2 Uterine hyperstimulation with FHR changes.
9.3
9.3. Analysis
Comparison 9 Extra‐amniotic PGE2 vs vaginal PGE2: all women, unfavourable cervix, Outcome 3 Caesarean section.
9.4
9.4. Analysis
Comparison 9 Extra‐amniotic PGE2 vs vaginal PGE2: all women, unfavourable cervix, Outcome 4 Maternal satisfaction.
9.5
9.5. Analysis
Comparison 9 Extra‐amniotic PGE2 vs vaginal PGE2: all women, unfavourable cervix, Outcome 5 Oxytocin augmentation.
9.6
9.6. Analysis
Comparison 9 Extra‐amniotic PGE2 vs vaginal PGE2: all women, unfavourable cervix, Outcome 6 Uterine hyperstimulation without FHR changes.
9.7
9.7. Analysis
Comparison 9 Extra‐amniotic PGE2 vs vaginal PGE2: all women, unfavourable cervix, Outcome 7 Instrumental vaginal delivery.
9.8
9.8. Analysis
Comparison 9 Extra‐amniotic PGE2 vs vaginal PGE2: all women, unfavourable cervix, Outcome 8 Meconium‐stained liquor.
9.9
9.9. Analysis
Comparison 9 Extra‐amniotic PGE2 vs vaginal PGE2: all women, unfavourable cervix, Outcome 9 Apgar score < 7 at 5 minutes.
9.10
9.10. Analysis
Comparison 9 Extra‐amniotic PGE2 vs vaginal PGE2: all women, unfavourable cervix, Outcome 10 Maternal side‐effects.
9.11
9.11. Analysis
Comparison 9 Extra‐amniotic PGE2 vs vaginal PGE2: all women, unfavourable cervix, Outcome 11 Maternal satisfaction ‐ embarassment.
10.1
10.1. Analysis
Comparison 10 Extra‐amniotic PGE2 vs vaginal PGE2: all women, favourable cervix, Outcome 1 Vaginal delivery not achieved within 24 hours.
11.1
11.1. Analysis
Comparison 11 Extra‐amniotic PGE2 vs vaginal PGE2: all primiparae, Outcome 1 Vaginal delivery not achieved within 24 hours.
11.2
11.2. Analysis
Comparison 11 Extra‐amniotic PGE2 vs vaginal PGE2: all primiparae, Outcome 2 Caesarean section.
11.3
11.3. Analysis
Comparison 11 Extra‐amniotic PGE2 vs vaginal PGE2: all primiparae, Outcome 3 Instrumental vaginal delivery.
11.4
11.4. Analysis
Comparison 11 Extra‐amniotic PGE2 vs vaginal PGE2: all primiparae, Outcome 4 Meconium‐stained liquor.
12.1
12.1. Analysis
Comparison 12 Extra‐amniotic PGE2 vs vaginal PGE2: all primiparae, unfavourable cervix, Outcome 1 Vaginal delivery not achieved within 24 hours.
12.2
12.2. Analysis
Comparison 12 Extra‐amniotic PGE2 vs vaginal PGE2: all primiparae, unfavourable cervix, Outcome 2 Caesarean section.
12.3
12.3. Analysis
Comparison 12 Extra‐amniotic PGE2 vs vaginal PGE2: all primiparae, unfavourable cervix, Outcome 3 Instrumental vaginal delivery.
12.4
12.4. Analysis
Comparison 12 Extra‐amniotic PGE2 vs vaginal PGE2: all primiparae, unfavourable cervix, Outcome 4 Meconium‐stained liquor.
13.1
13.1. Analysis
Comparison 13 Extra‐amniotic PGE2 vs vaginal PGE2: all primiparae, favourable cervix, Outcome 1 Vaginal delivery not achieved within 24 hours.
14.1
14.1. Analysis
Comparison 14 Extra‐amniotic PGE2 vs vaginal PGE2: all multiparae (without prior CS), Outcome 1 Vaginal delivery not achieved within 24 hours.
15.1
15.1. Analysis
Comparison 15 Extra‐amniotic PGE2 vs vaginal PGE2: all multiparae, unfavourable cervix, Outcome 1 Vaginal delivery not achieved within 24 hours.
16.1
16.1. Analysis
Comparison 16 Extra‐amniotic PGE2 vs vaginal PGE2: all multiparae, favourable cervix, Outcome 1 Vaginal delivery not achieved within 24 hours.
17.1
17.1. Analysis
Comparison 17 Extra‐amniotic PGE2 vs cervical PGE2: all women, Outcome 1 Hyperstimulation with FHR changes.
17.2
17.2. Analysis
Comparison 17 Extra‐amniotic PGE2 vs cervical PGE2: all women, Outcome 2 Meconium‐stained liquor.
17.3
17.3. Analysis
Comparison 17 Extra‐amniotic PGE2 vs cervical PGE2: all women, Outcome 3 Caesarean section.
17.4
17.4. Analysis
Comparison 17 Extra‐amniotic PGE2 vs cervical PGE2: all women, Outcome 4 Vomiting.
17.5
17.5. Analysis
Comparison 17 Extra‐amniotic PGE2 vs cervical PGE2: all women, Outcome 5 "Other" maternal infection.
17.6
17.6. Analysis
Comparison 17 Extra‐amniotic PGE2 vs cervical PGE2: all women, Outcome 6 All maternal side‐effects.
17.7
17.7. Analysis
Comparison 17 Extra‐amniotic PGE2 vs cervical PGE2: all women, Outcome 7 "Other" maternal fever other than infection.
17.8
17.8. Analysis
Comparison 17 Extra‐amniotic PGE2 vs cervical PGE2: all women, Outcome 8 instrumental vaginal delivery.
17.9
17.9. Analysis
Comparison 17 Extra‐amniotic PGE2 vs cervical PGE2: all women, Outcome 9 Cervix unfavourable > 12‐24 hours.
17.10
17.10. Analysis
Comparison 17 Extra‐amniotic PGE2 vs cervical PGE2: all women, Outcome 10 Serious maternal complications.
18.1
18.1. Analysis
Comparison 18 Extra‐amniotic PGE2 vs cervical PGE2: all primiparae, Outcome 1 Caesarean section.
19.1
19.1. Analysis
Comparison 19 Extra‐amniotic PGE2 vs cervical PGE2: all women, unfavourable cervix, Outcome 1 Caesarean section.
20.1
20.1. Analysis
Comparison 20 Extra‐amniotic PGE2 vs cervical PGE2: all primiparae, unfavourable cervix, Outcome 1 Caesarean section.
21.1
21.1. Analysis
Comparison 21 Extra‐amniotic PGE2 vs cervical PGE2: all multiparae, Outcome 1 Caesarean section.
22.1
22.1. Analysis
Comparison 22 Extra‐amniotic PGE2 vs cervical PGE2: all multiparae, unfavourable cervix, Outcome 1 Caesarean section.
23.1
23.1. Analysis
Comparison 23 Extra‐amniotic PGE2 vs oxytocin: all women, Outcome 1 Caesarean section.
23.2
23.2. Analysis
Comparison 23 Extra‐amniotic PGE2 vs oxytocin: all women, Outcome 2 Instrumental vaginal delivery.
24.1
24.1. Analysis
Comparison 24 Extra‐amniotic PGE2 vs oxytocin: all women, unfavourable cervix, Outcome 1 Caesarean section.
24.2
24.2. Analysis
Comparison 24 Extra‐amniotic PGE2 vs oxytocin: all women, unfavourable cervix, Outcome 2 Instrumental vaginal delivery.
25.1
25.1. Analysis
Comparison 25 Extra‐amniotic PGE2 vs oxytocin: all primiparae, Outcome 1 Caesarean section.
25.2
25.2. Analysis
Comparison 25 Extra‐amniotic PGE2 vs oxytocin: all primiparae, Outcome 2 Instrumental vaginal delivery.
26.1
26.1. Analysis
Comparison 26 Extra‐amniotic PGE2 vs oxytocin: all primiparae, unfavourable cervix, Outcome 1 Caesarean section.
26.2
26.2. Analysis
Comparison 26 Extra‐amniotic PGE2 vs oxytocin: all primiparae, unfavourable cervix, Outcome 2 Instrumental vaginal delivery.
27.1
27.1. Analysis
Comparison 27 Extra‐amniotic PGF2 alpha vs Foley catheter: all women, Outcome 1 Uterine hyperstimulation with FHR changes.
27.2
27.2. Analysis
Comparison 27 Extra‐amniotic PGF2 alpha vs Foley catheter: all women, Outcome 2 Caesarean section.
27.3
27.3. Analysis
Comparison 27 Extra‐amniotic PGF2 alpha vs Foley catheter: all women, Outcome 3 Serious neonatal morbidity or perinatal death.
27.4
27.4. Analysis
Comparison 27 Extra‐amniotic PGF2 alpha vs Foley catheter: all women, Outcome 4 Oxytocin augmentation.
27.5
27.5. Analysis
Comparison 27 Extra‐amniotic PGF2 alpha vs Foley catheter: all women, Outcome 5 Instrumental vaginal delivery.
27.6
27.6. Analysis
Comparison 27 Extra‐amniotic PGF2 alpha vs Foley catheter: all women, Outcome 6 Neonatal intensive care unit admission.
27.7
27.7. Analysis
Comparison 27 Extra‐amniotic PGF2 alpha vs Foley catheter: all women, Outcome 7 Perinatal death.
28.1
28.1. Analysis
Comparison 28 Extra‐amniotic PGF2 alpha vs Foley catheter: all women, unfavourable cervix, Outcome 1 Uterine hyperstimulation with FHR changes.
28.2
28.2. Analysis
Comparison 28 Extra‐amniotic PGF2 alpha vs Foley catheter: all women, unfavourable cervix, Outcome 2 Caesarean section.
28.3
28.3. Analysis
Comparison 28 Extra‐amniotic PGF2 alpha vs Foley catheter: all women, unfavourable cervix, Outcome 3 Serious neonatal morbidity or perinatal death.
28.4
28.4. Analysis
Comparison 28 Extra‐amniotic PGF2 alpha vs Foley catheter: all women, unfavourable cervix, Outcome 4 Oxytocin augmentation.
28.5
28.5. Analysis
Comparison 28 Extra‐amniotic PGF2 alpha vs Foley catheter: all women, unfavourable cervix, Outcome 5 Instrumental vaginal delivery.
28.6
28.6. Analysis
Comparison 28 Extra‐amniotic PGF2 alpha vs Foley catheter: all women, unfavourable cervix, Outcome 6 Neonatal intensive care unit admission.
28.7
28.7. Analysis
Comparison 28 Extra‐amniotic PGF2 alpha vs Foley catheter: all women, unfavourable cervix, Outcome 7 Perinatal death.
29.1
29.1. Analysis
Comparison 29 Extra‐amniotic PGE2 alpha vs Foley only: all women, Outcome 1 Caesarean section.
29.2
29.2. Analysis
Comparison 29 Extra‐amniotic PGE2 alpha vs Foley only: all women, Outcome 2 Hyperstimulation with FHR changes.
29.3
29.3. Analysis
Comparison 29 Extra‐amniotic PGE2 alpha vs Foley only: all women, Outcome 3 Meconium‐stained liquor.
29.4
29.4. Analysis
Comparison 29 Extra‐amniotic PGE2 alpha vs Foley only: all women, Outcome 4 All maternal side‐effects.
29.5
29.5. Analysis
Comparison 29 Extra‐amniotic PGE2 alpha vs Foley only: all women, Outcome 5 Vomiting.
29.6
29.6. Analysis
Comparison 29 Extra‐amniotic PGE2 alpha vs Foley only: all women, Outcome 6 "Other" maternal infection.
29.7
29.7. Analysis
Comparison 29 Extra‐amniotic PGE2 alpha vs Foley only: all women, Outcome 7 "Other" maternal fever other than infection.
29.8
29.8. Analysis
Comparison 29 Extra‐amniotic PGE2 alpha vs Foley only: all women, Outcome 8 Cervix unfavourable > 12‐24 hours.
29.9
29.9. Analysis
Comparison 29 Extra‐amniotic PGE2 alpha vs Foley only: all women, Outcome 9 Serious maternal complications.
29.10
29.10. Analysis
Comparison 29 Extra‐amniotic PGE2 alpha vs Foley only: all women, Outcome 10 Instrumental vaginal delivery.
30.1
30.1. Analysis
Comparison 30 Extra‐amniotic PGF2 alpha vs vaginal misoprostol, Outcome 1 Vaginal delivery not achieved in 24 hours.
30.2
30.2. Analysis
Comparison 30 Extra‐amniotic PGF2 alpha vs vaginal misoprostol, Outcome 2 Caesarean section.
30.3
30.3. Analysis
Comparison 30 Extra‐amniotic PGF2 alpha vs vaginal misoprostol, Outcome 3 Serious maternal morbidity or death.
30.4
30.4. Analysis
Comparison 30 Extra‐amniotic PGF2 alpha vs vaginal misoprostol, Outcome 4 Oxytocin augmentation.
30.5
30.5. Analysis
Comparison 30 Extra‐amniotic PGF2 alpha vs vaginal misoprostol, Outcome 5 Uterine rupture.
30.6
30.6. Analysis
Comparison 30 Extra‐amniotic PGF2 alpha vs vaginal misoprostol, Outcome 6 Meconium‐stained liquor.
30.7
30.7. Analysis
Comparison 30 Extra‐amniotic PGF2 alpha vs vaginal misoprostol, Outcome 7 Neonatal intensive care unit admission.
30.8
30.8. Analysis
Comparison 30 Extra‐amniotic PGF2 alpha vs vaginal misoprostol, Outcome 8 Perinatal death.
30.9
30.9. Analysis
Comparison 30 Extra‐amniotic PGF2 alpha vs vaginal misoprostol, Outcome 9 Postpartum haemorrhage.
30.10
30.10. Analysis
Comparison 30 Extra‐amniotic PGF2 alpha vs vaginal misoprostol, Outcome 10 Fetal distress necessitating caesarean.
30.11
30.11. Analysis
Comparison 30 Extra‐amniotic PGF2 alpha vs vaginal misoprostol, Outcome 11 Apgar < 5 (time unknown).
See this image and copyright information in PMC

References

References to studies included in this review

Allouche 1993 {published data only}
    1. Allouche C. Comparison of three methods of cervical ripening. Results of a prospective randomized trial [Comparaison de trois methodes de maturation cervicale: resultats d'une etude prospective randomisee]. [MD thesis]. Caen, France: University of Caen, France, 1993:1‐160. - PubMed
    1. Allouche C, Dommesent D, Barjot P, Levy G. Cervical ripening: comparison of three methods. Preliminary results of a randomized prospective study [Maturations cervicales: comparaison de trois methodes. Resultats preliminaires d'une etude prospective randomisee]. Revue Francaise de Gynecologie et d'Obstetrique 1993;88:492‐7. - PubMed
Clarke 1980 {published data only}
    1. Clarke GA, Letchworth AT, Noble AD. Comparative trial of extra‐amniotic and vaginal prostaglandin E2 in tylose gel for induction of labor. Journal of Perinatal Medicine 1980;8:236‐40. - PubMed
Fenton 1985 {published data only}
    1. Fenton DW, Speedie J, Duncan SLB. Does cervical ripening with PGE2 affect subsequent uterine activity in labour?. Acta Obstetricia et Gynecologica Scandinavica 1985;64:27‐30. - PubMed
Greer 1989 {published data only}
    1. Greer IA, Calder AA. Pre‐induction cervical ripening with extra‐amniotic and vaginal prostaglandin E2. Journal of Obstetrics and Gynaecology 1989;10:18‐22.
    1. Greer IA, Calder AA. Preinduction cervical ripening with extra‐amniotic and vaginal prostaglandin E2. Proceedings of 1st European Congress on Prostaglandins in Reproduction; 1988 July 6‐9; Vienna, Austria. 1988:144.
Mahomed 1988 {published data only}
    1. Mahomed K. Foley catheter under traction versus extra‐amniotic prostaglandin gel in pre‐treatment of unripe cervix ‐ a randomised controlled trial. Central African Journal of Medicine 1988;34:98‐102. - PubMed
Majoko 2002a {published data only}
    1. Majoko F, Zwizwai M, Lindmark G, Nystrom L. Labor induction with vaginal misoprostol and extra‐amniotic prostaglandin F2 alpha gel. International Journal of Gynecology & Obstetrics 2002;76:127‐33. - PubMed
Parewicjk 1986 {published data only}
    1. Parewijck W. Cervical ripening: randomized study of extra‐amniotic and intracervical prostaglandin E2 gel. Personal communication 1987.
    1. Parewijck W, Thiery M. Cervical ripening: randomized comparative study of extra‐amniotic vs intracervical PGE2 gel. Proceedings of 10th European Congress of Perinatal Medicine; 1986 Aug 12‐16; Leipzig, Germany. 1986:165.
Quinn 1981 {published data only}
    1. Quinn MA, Murphy AJ, Kuhn RJP, Robinson HP, Brown JB. A double blind trial of extra‐amniotic oestriol and prostaglandin F2alpha gels in cervical ripening. British Journal of Obstetrics and Gynaecology 1981;88:644‐9. - PubMed
Shepherd 1976 {published data only}
    1. Shepherd J, Sims CD, Craft I. Extra‐amniotic prostaglandin E2 and the unfavourable cervix. Lancet 1976;2:709‐10. - PubMed
Sherman 2001 {published data only}
    1. Sherman DJ, Frenkel E, Pansky M, Caspi E, Bukovsy I, Langer R. Balloon cervical ripening with extra‐amniotic infusion of saline or prostaglandin e2: a double‐blind, randomized controlled study. Obstetrics and Gynaecology 2001;97(3):375‐80. - PubMed
    1. Sherman DJ, Raaziel A, Arieli S, Bukovski I, Caspi E. Cervical ripening with extra‐amniotic instillation (XAml) of saline and prostaglandin E2 (PGE2) solutions. American Journal of Obstetrics and Gynecology 1993;168:430.
Stewart 1985 {published data only}
    1. Stewart P. Prostaglandins in the difficult induction. In: Wood C editor(s). The role of prostaglandins in labour. London: RSM Services, 1985:72‐3.
    1. Stewart P, Kennedy JH, Hillan E, Calder AA. The unripe cervix: management with vaginal or extra‐amniotic prostaglandin E2. Journal of Obstetrics and Gynaecology 1983;4:90‐3.
Wilson 1978 {published data only}
    1. Wilson PD. A comparison of four methods of ripening the unfavourable cervix. British Journal of Obstetrics and Gynaecology 1978;85:941‐4. - PubMed

References to studies excluded from this review

Calder 1974 {published data only}
    1. Calder AA, Moar VA, Ounsted MK, Turnbull AC. Increased bilirubin levels in neonates after induction of labour by intravenous prostaglandin E2 or oxytocin. Lancet 1974;2:1339‐42. - PubMed
Fletcher 1993 {published data only}
    1. Fletcher H, Mitchell S, Frederick J, Simeon D. Extra‐amniotic misoprostol as a cervical ripening agent [abstract]. West Indian Medical Journal 1993;42:16. - PubMed
Keirse 1982 {published data only}
    1. Keirse MJNC, Thiery M, Parewijck W, Mitchell MD. Extra‐amniotic insertion of foreign materials to ripen the cervix has a durable effect on prostaglandin synthesis. Proceedings of 8th European Congress of Perinatal Medicine; 1982 Sept 7‐10; Brussels, Belgium. 1982:77.
Reichel 1985 {published data only}
    1. Reichel R, Husslein P, Goschen K, Rasche M, Sinzinger, H. Resorption of prostaglandin e2 following various methods of local administration for ripening of the cervix and end the induction of labor. Wiener Klinische Wochenschrift 1985;97:500‐3. - PubMed
Salamalekis 1990 {published data only}
    1. Salamalekis E, Loghis C, Kassanos D, Traka A, Zourlas PA. Comparison of extra‐amniotic prostaglandin F2alpha and dinoprostone use for labor induction after second trimester intrauterine fetal death. Proceedings of 12th European Congress of Perinatal Medicine; 1990 Sept 11‐14; Lyon, France. 1990:228.
Thiery 1981 {published data only}
    1. Thiery M, Parewijck W, Martens G, Derom R, Kets H. Extra‐amniotic prostaglandin E2 gel vs amniotomy for elective induction of labour. Zeitschrift fur Geburtshilfe und Perinatologie 1981;185:323‐6. - PubMed
Thoumsin 1982 {published data only}
    1. Thoumsin HJ, Renwart JP, Lambotte R. Cervical ripening and/or labour induction by extra‐amniotic implantations of PGE2 tablets. Proceedings of 8th European Congress of Perinatal Medicine; 1982 Sept 7‐10; Brussels, Belgium. 1982:76.
Toppozada 1994 {published data only}
    1. Toppozada MK, Shaala SA, Anwar MY, Haiba NA, Abdrabbo S, El‐Absy HM. Termination of pregnancy with fetal death in the second and third trimesters ‐ the double balloon versus extra‐amniotic prostaglandin. International Journal of Gynecology & Obstetrics 1994;45:269‐73. - PubMed
Tsalacopoulo 1982 {published data only}
    1. Tsalacopoulos G, Bloch B, Rush JM. Intramuscular and extra‐amniotic 15‐(S)‐15‐methyl‐prostaglandin F2alpha in intra‐uterine death. South African Medical Journal 1982;61:825‐8. - PubMed

References to studies awaiting assessment

Majoko 2002b {published data only}
    1. Majoko F. Zwizwai M, Nystom L. Lindmark G. Vaginal misoprostol for induction of labour: a more effective agent than prostaglandin f2 alpha gel and prostaglandin e2 pessary. Central African Journal of Medicine 2002;48(11‐12):123‐8. - PubMed

Additional references

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