The studies in this review are limited by sample size which are often divided into multiple comparison groups. Most comparisons showed 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.
Foley catheter under traction versus extra-amniotic prostaglandin gel in pre-treatment of unripe cervix--a randomised controlled trial.