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. 2019 Oct 18;2019(10):CD001233. doi: 10.1002/14651858.CD001233.pub3

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.
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
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
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