ten Eikelder 2016.
Methods | RCT | |
Participants | Inclusion: singleton, scheduled for labour induction, GA ≥ 37 wk; BS < 6, vertex presentation, intact membranes. Exclusion: placenta previa, previous uterine scar. contraindication to receive or known allergy to latex or PG. |
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Interventions | 1. Foley catheter (n = 921): 30 mL, no traction, replaced after 48 hours, max 4 days 2. Low dose oral misoprostol (n = 924): 50 mg every 4 hours, max 3 times a day, max 4 days |
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Outcomes | Primary outcome for safety was composite of fluxus postpartum and asphyxia, and for effectiveness CS rate. Secondary outcomes included maternal and neonatal outcomes, total induction time, interval between randomisation and active phase | |
Notes | Setting: multicentre, 6 tertiary‐care and 23 secondary‐care hospitals, the Netherlands Study period: July 2012 to October 2013, Funding: FondsNutsOhra, no role in study design, data collection, data analysis, data interpretation, writing of the report or publication Declarations of interest: none declared |
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Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | Computer‐generated numbers, block randomisation, stratified by parity and centre |
Allocation concealment (selection bias) | Low risk | Web‐based allocation |
Blinding of participants and personnel (performance bias) All outcomes | Unclear risk | Not feasible due to nature of intervention |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Not reported |
Incomplete outcome data (attrition bias) All outcomes | Low risk | ITT, no missing cases. missing data in primary outcome (pH in umbilical artery). similar reasons for missing data across groups, pre‐specified in protocol, anticipated on as followed: data missing for umbilical artery pH and a 5‐minute AS of less than 7, the outcome was classified as abnormal; for patients with missing data for umbilical artery pH and a 5‐minute AS of 7 or more, the neonatal outcome was classified as normal. |
Selective reporting (reporting bias) | Low risk | All pre‐specified outcomes were reported in results |
Other bias | Low risk | No other bias detected |