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Methods to induce labour: a systematic review, network meta-analysis and cost-effectiveness analysis

Z Alfirevic, et al.

BJOG 22 March 2016 Online. DOI: 10.1111/1471-0528.13981

Editor’s comment: Prof. Jim Thornton: Network meta-analysis of methods to induce labour
611 studies comparing 31 active interventions were analysed. Intravenous oxytocin with amniotomy and vaginal misoprostol (≥50 μg) were most likely to achieve vaginal delivery within 24 hours. Titrated low-dose oral misoprostol achieved the lowest odds of caesarean section. Buccal/sublingual and titrated (low-dose) misoprostol showed the highest probability of being cost-effective. However, the quality of many of the primary studies was poor and there was considerable uncertainty in all the estimates.

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Commentaries by Editor Prof. Jim Thornton