Methods	RCT.
Participants	Setting: 91 women with prolonged pregnancy (gestational age > 41 weeks) attending a Florida, USA hospital Inclusion criteria: uncomplicated pregnancy, reliable dating, Bishop score < 9, reactive NST and ultrasound Exclusion criteria: vaginal bleeding, ruptured membranes, macrosomia (estimated fetal weight > 4500 g) previous uterine surgery or stillbirth, abnormal FHR or ultrasound, regular contractions
Interventions	Intervention group: daily self-administered vaginal PGE2 2mg before bed (women were given instructions re placement and storage of suppositories) Comparison group: self-administered placebo. Telephone contact available 24 hrs per day for both groups. Twice weekly clinic attendance for post-dates surveillance (NST and AFV); induction if indicated or at 44 weeks
Outcomes	CS rates, chorioamnionitis, Apgar score at 5 min, NICU admission
Notes
Risk of bias
Item	Authors’ judgement	Description
Adequate sequence generation?	Yes	Computer generated.
Allocation concealment?	Yes	Coded drug boxes.
Blinding? Women	Yes	Described as “double blind” placebo controlled.
Blinding? Clinical staff	Yes
Incomplete outcome data addressed? All outcomes	Unclear	91 were enrolled but 11 were lost to follow up (3 were excluded as they were non compliant)