Are the Novel Labour Induction Algorithms Associated with Increased Efficiency and Vaginal Delivery Rates?

Objective: To determine whether combined methods of labour preinduction are more effective and safer compared to a single method. In addition, we assessed whether shorter Foley catheter maintenance is more beneficial in reducing the time from preinduction to delivery. A significant topic in medical practice remains the use of prostaglandins (PGs) in women after previous cesarean delivery.

Data Sources: We carried out a systematic search in multiple databases, including PubMed, Scopus, and Medline/Embase from January 1, 2018, up to December 1, 2023, using a combination of words including "induction of labour", "dinoprostone vaginal insert", "Foley catheter", "oral misoprostol", "vaginal birth after cesarean".

Study Selection: Only data from prospective cohort studies, and randomized controlled trials (RCTs) were included in the analysis. We ruled out case reports, case series, and retrospective cohort studies.

Data Extraction And Data Synthesis: The subject-related articles were processed according to Preferred Reporting Items in Systematic Reviews and Meta-Analyses guidelines. We evaluated 12 studies, of which 10 of them were randomized controlled trials, and 2 papers were prospective observational studies.

Conclusion: Combined methods of labour preinduction are more effective in reducing induction delivery interval and are equally safe. Preinduction of labour by PGs in a woman with a previous cesarean delivery should consider predictors of successful vaginal delivery. It is worth considering the preinduction of labour with a Foley catheter maintained for a shorter time in both primiparous and multiparous women.