Efficacy and Safety of Vaginal Misoprostol Compared to Vaginal Dinoprostone for Induction of Labour: A Systematic Review and Meta-Analysis

Efficacy and Safety of Vaginal Misoprostol Compared to Vaginal Dinoprostone for Induction of Labour: A Systematic Review and Meta-Analysis | Authorea try { document.documentElement.classList.add('js'); } catch (e) { } var _gaq = _gaq || []; _gaq.push(['_setAccount', 'G-8VDV14Y67G']); _gaq.push(['_trackPageview']); (function() { var ga = document.createElement('script'); ga.type = 'text/javascript'; ga.async = true; ga.src = ('https:' == document.location.protocol ? 'https://ssl' : 'http://www') + '.google-analytics.com/ga.js'; var s = document.getElementsByTagName('script')[0]; s.parentNode.insertBefore(ga, s); })(); Skip to main content Preprints Collections Wiley Open Research IET Open Research Ecological Society of Japan All Collections About About Authorea FAQs Contact Us Quick Search anywhere Search for preprint articles, keywords, etc. Search Search ADVANCED SEARCH SCROLL This is a preprint and has not been peer reviewed. Data may be preliminary. 23 January 2026 V1 Latest version Share on Efficacy and Safety of Vaginal Misoprostol Compared to Vaginal Dinoprostone for Induction of Labour: A Systematic Review and Meta-Analysis Authors : Georgina Andersson 0009-0002-0522-5084 , Benjamin Greenfield , Alexandra Hunt , Amr Malawany , Ben Luke Choo , William Dixon , David Lissauer , Andrew Weeks 0000-0002-1909-337X , A. Sharp 0000-0003-3396-7464 , Gemma Clayton , and Abi Merriel 0000-0003-0352-2106 [email protected] Authors Info & Affiliations https://doi.org/10.22541/au.176915366.63172773/v1 153 views 113 downloads Contents Abstract Supplementary Material Information & Authors Metrics & Citations View Options References Figures Tables Media Share Abstract Background: In 2023-24, 33% of labours were induced in England. The prostaglandin dinoprostone is commonly used, but evidence is increasing that misoprostol may be a better alternative. Objectives: Compare the efficacy and safety of vaginal dinoprostone with vaginal misoprostol for labour induction. Search Strategy: Electronic databases (Medline, Scopus, CINAHL, Cochrane Central Register) were searched in 2025. Selection Criteria: Randomised controlled trials comparing singleton, term inductions with vaginal dinoprostone or misoprostol published after 2000. Primary outcome was vaginal births within 24 hours. Secondary outcomes included birth mode, induction to birth interval, oxytocin augmentation, uterine hyperstimulation and adverse maternal or neonatal outcomes. Data Collection and Analysis: Data extraction used a standardised proforma including the Cochrane Risk of Bias. A random effects meta-analysis was performed using R. Main Results: From 8,529 records, 44 papers reported 7,040 participants induced with vaginal misoprostol and 6,604 with dinoprostone. Risk of bias was moderate. Participants given misoprostol were 48% (OR 1.48 95% CI 1.20, 1.84) more likely to achieve vaginal birth within 24 hours compared with those given dinoprostone, although heterogeneity was high. The rates of the above-mentioned secondary outcomes were comparable. In the misoprostol group, fewer patients required augmentation with oxytocin (OR 0.51 95% CI 0.40, 0.65). Conclusion: Induction of labour with vaginal misoprostol seems to improve the rate of vaginal birth within 24 hours when compared to dinoprostone without increasing the incidence of adverse events with fewer patients requiring oxytocin augmentation. We encourage consideration of vaginal misoprostol as a first-line agent for labour induction. Supplementary Material File (efficacy and safety of vaginal misoprostol compared to vaginal dinoprostone for induction of labour- a systematic review and meta-analysis.docx) Download 55.32 KB Information & Authors Information Version history V1 Version 1 23 January 2026 Copyright This work is licensed under a Non Exclusive No Reuse License. Keywords intrapartum care labour: induction labour: management reproductive science: prostaglandins Authors Affiliations Georgina Andersson 0009-0002-0522-5084 University of Liverpool Institute of Life Course and Medical Sciences View all articles by this author Benjamin Greenfield University of Liverpool Institute of Life Course and Medical Sciences View all articles by this author Alexandra Hunt Liverpool Women's NHS Foundation Trust View all articles by this author Amr Malawany Liverpool Women's NHS Foundation Trust View all articles by this author Ben Luke Choo Liverpool Women's NHS Foundation Trust View all articles by this author William Dixon University of Liverpool Institute of Life Course and Medical Sciences View all articles by this author David Lissauer University of Liverpool Institute of Life Course and Medical Sciences View all articles by this author Andrew Weeks 0000-0002-1909-337X University of Liverpool Institute of Life Course and Medical Sciences View all articles by this author A. Sharp 0000-0003-3396-7464 University of Liverpool Institute of Life Course and Medical Sciences View all articles by this author Gemma Clayton University of Bristol View all articles by this author Abi Merriel 0000-0003-0352-2106 [email protected] University of Liverpool Institute of Life Course and Medical Sciences View all articles by this author Metrics & Citations Metrics Article Usage 153 views 113 downloads .FvxKWukQNSOunydq8rnd { width: 100px; } Citations Download citation Georgina Andersson, Benjamin Greenfield, Alexandra Hunt, et al. Efficacy and Safety of Vaginal Misoprostol Compared to Vaginal Dinoprostone for Induction of Labour: A Systematic Review and Meta-Analysis. Authorea . 23 January 2026. DOI: https://doi.org/10.22541/au.176915366.63172773/v1 If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download. 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