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Commentary on: Alfirevic Z, Keeney E, Dowswell T, et al. Methods to induce labour: a systematic review, network meta-analysis and cost-effectiveness analysis. BJOG 2016;123:1462–70.
The goal of induction of labour (IOL) is to achieve vaginal delivery by stimulation of uterine contractions before the spontaneous onset of labour. Variations in the management of IOL likely affect rates of caesarean delivery (CD), particularly the use of cervical ripening agents for the unfavourable cervix. This systematic review and meta-analysis looks at the various methods of labour induction and compares them from a clinical and cost-effectiveness perspective.
This was a review of randomised controlled trials (RCTs) examining pharmacological, mechanical and complementary (ie, acupuncture) interventions to induce labour. Outcomes included were vaginal delivery not achieved within 24 hours (VD24); uterine hyperstimulation with fetal heart rate (FHR) changes; CD; serious maternal and neonatal morbidity or mortality; instrumental delivery; maternal satisfaction with the method …
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