Table 1 Characteristics of included studies
First author, year | Country | Intervention | Participants number | Age, year | Gestational weeks | Details of interventions | Outcomes |
|---|---|---|---|---|---|---|---|
Sanchez-Ramos, 1997 | USA | Misoprostol | 70 | 23.8 ± 5.7 | 38.6 ± 1.6 | Route: Vaginal; Frequency: Every 4 h; Dose: 50 ug per dose (maximum 600 ug) | 1, 2, 6, 7, 8, 9, 11, 13, 16 |
Oxytocin | 71 | 23.3 ± 5.0 | 38.5 ± 1.6 | Route: Intravenous; Frequency: Increase as needed every 30 min; Rate: Starting at 1–2 mU/min | |||
Wing, 1998 | USA | Misoprostol | 98 | NR | 38.7 ± 1.5 | Route: Vaginal; Frequency: Repeat dose 6 h later if no response; Dose: 25 ug per dose (maximum 50 ug) | 1, 2, 6, 10, 11, 13 |
Oxytocin | 99 | NR | 38.9 ± 1.6 | Route: Intravenous; Frequency: Increase every 30 min; Rate: Starting at 1 mU/min, maximum 20 mU/min | |||
Butt, 1999 | Canada | Misoprostol | 55 | 28.5 ± 5.9 | 39.4 ± 1.4 | Route: Oral; Frequency: Every 4 h as needed; Dose: 50 ug per dose | 3, 7, 10, 11, 12, 13, 14, 16, 17 |
Oxytocin | 53 | 28.6 ± 4.3 | 39.6 ± 1.3 | Route: Intravenous; Frequency: Increase in increments of 2 mIU/min every 15–30 min; Rate: Starting at 2 mIU/min | |||
Ngai, 2000 | China | Misoprostol | 40 | 28.9 ± 4.0 | 38.9 ± 1.7 | Route: Oral; Frequency: Every 4 h; Dose: 100 ug per dose (maximum 300 ug) | 2, 3, 5, 10, 16 |
Oxytocin | 40 | 30.7 ± 3.0 | 39.4 ± 1.5 | Route: Intravenous; Frequency: Double every 15 min; Rate: Starting at 1 mIU/min, maximum 32 mIU/min | |||
Crane, 2003 | Canada | Misoprostol | 52 | 30.0 ± 4.7 | 38.9 ± 1.1 | Route: Oral; Frequency: Every 4 h as needed; Dose: 75 ug per dose | 1, 3, 4, 5, 6, 7, 8, 10, 11, 12, 13, 14, 15, 16, 17 |
Oxytocin | 53 | 29.5 ± 5.0 | 39.7 ± 0.9 | Route: Intravenous; Frequency: Increase every 30 min; Rate: Starting at 2 mIU/min | |||
Mozurkewich, 2003 | USA | Misoprostol | 159 | Mean: 27.5 | Mean: 39.2 | Route: Oral; Frequency: Every 6Â h; Dose: 100 ug per dose (maximum 200 ug) | 5, 6, 7, 8, 9, 10, 13, 15, 17 |
Oxytocin | 146 | Mean: 27.2 | Mean: 39.0 | Route: Intravenous; Frequency: Increase at 20–30 min intervals; Rate: Starting at 1–2 mU/min | |||
Zeteroğlu, 2006 | Turkey | Misoprostol | 48 | 25.9 ± 4.5 | 38.3 ± 1.3 | Route: Vaginal; Frequency: Every 4 h; Dose: 50 ug per dose (maximum 200ug) | 2, 5, 6, 7, 8, 9, 10, 11, 13, 16 |
Oxytocin | 49 | 26.7 ± 4.6 | 38.3 ± 1.3 | Route: Intravenous; Frequency: Increase by 2 mU/min every 20 min; Rate: Starting at 2 mU/min, maximum 30 mU/min | |||
Maskey, 2013 | Nepal | Misoprostol | 50 | 25.3 ± 3.8 | 39.2 ± 1.3 | Route: Oral; Frequency: Every 4 h; Dose: 50 ug per dose (maximum 300 ug) | 2, 8, 10, 11, 17 |
Oxytocin | 50 | 25.9 ± 4.0 | 39.2 ± 1.0 | Route: Intravenous; Frequency: Increase every 30 min; Rate: Starting dose depends on parity (2.5 mU/min for multigravida, 5 mU/min for primigravida), maximum (15 mU/min for multigravida, 30 mU/min for primigravida | |||
Mbaluka, 2014 | Kenya | Misoprostol | 41 | 24.0 ± 4.4 | 38.0 ± 1.5 | Route: Oral; Frequency: Every 2 h; Dose: 20 mcg per dose (maximum 80 mcg) | 2, 4, 5, 6, 7, 17 |
Oxytocin | 42 | 24.0 ± 4.4 | 38.0 ± 1.5 | Route: Intravenous; Frequency: According to WHO protocol | |||
Shabana, 2015 | Egypt | Misoprostol | 50 | 24.7 ± 3.2 | 38.5 ± 0.7 | Route: Oral; Frequency: Every 4 h; Dose: 100 ug per dose (maximum 300 ug) | 2, 5, 7, 10, 13 |
Oxytocin | 50 | 25.1 ± 3.5 | 38.5 ± 0.7 | Route: Intravenous; Frequency: Increase by 4 mU/min every 30 min; Rate: Starting at 4 mU/min, maximum 32 mU/min | |||
Anjum, 2016 | India | Misoprostol | 142 | 23.9 ± 4.9 | 36.1 ± 4.0 | Route: Oral; Frequency: Every 6 h; Dose: 100 µg per dose (maximum 300 ug) | 2, 5, 6, 8, 9, 10, 17 |
Oxytocin | 124 | 24.4 ± 4.9 | 37.0 ± 3.4 | Route: Intravenous; Rate: Starting at 2 mIU/min, maximum primigravida up to 20 mIU/min, multigravida up to 10 mIU/min | |||
Pouralil, 2018 | Iran | Misoprostol | 120 | 25.9 ± 4.7 | 38.9 ± 1.0 | Route: Sublingual; Frequency: Every 4 h; Dose:25 µg per dose (maximum 150 ug) | 3, 4, 5, 6, 8, 10, 14 |
Oxytocin | 120 | 26.2 ± 5.9 | 39.1 ± 1.0 | Route: Intravenous; Frequency: Increasing 2 mU/min each 20 min; Rate: Starting with 2 mU/min | |||
Abdel-Aal, 2020 | Egypt | Misoprostol | 50 | 26.1 ± 4.5 | 38.7 ± 1.0 | Route: Sublingual; Frequency: Every 6 h; Dose: 50 µg per dose (maximum 200 ug) | 2, 3, 5, 6, 7, 8, 10, 12, 14 |
Oxytocin | 50 | 25.2 ± 4.2 | 38.9 ± 1.2 | Route: Intravenous; Frequency: Increasing 2 mU/min each 20 min; Rate: Starting with 2 mU/min | |||
Bhatu, 2020 | India | Misoprostol | 100 | NR | ≥ 37 | Route: Vaginal; Frequency: Every 6 h, maximum 3 doses; Dose: 25 ug per dose (maximum 75 ug) | 5, 17 |
Oxytocin | 100 | NR | ≥ 37 | Route: Intravenous; Frequency: Incremented at 30 min interval; Rate: 8 drops/mt (5 mU/mt) maximum: 48 drops/mt (30 mU/mt) | |||
Tayab, 2021 | India | Misoprostol | 100 | NR | ≥ 37 | Route: Oral; Frequency: Every 4 h; Dose: 25 ug per dose (maximum 100 ug) | 2, 5, 6, 12, 14, 17 |
Oxytocin | 100 | NR | ≥ 37 | Route: Intravenous; Frequency: Increased gradually up to 60 drops/minute; Rate: 2.5 units added, maximum 5 units of 60 drops/minute | |||
Muhmed, 2022 | Egypt | Misoprostol | 55 | 25.2 ± 4.2 | 40.0 ± 1.2 | Route: Vaginal; Frequency: 2 h a dose; Dose: 25 mcg per dose | 4, 5, 7, 8, 10, 11, 13 |
Oxytocin | 55 | 25.3 ± 4.9 | 40.0 ± 1.3 | Route: Intravenous; Frequency: Increased by 2 mIU/min every 15 min; Rate: 2 mIU/min (4 drops per minute), maximum 36 mIU/min | |||
Unthanan, 2022 | Thailand | Misoprostol | 85 | 27.1 ± 6.2 | 38.6 ± 1.2 | Route: Sublingual; Frequency: Every 2 h a dose; Dose: 25 ug per dose (maximum 150 ug) | 2, 3, 5, 6, 7, 9, 11, 12, 14 |
Oxytocin | 85 | 28.2 ± 5.9 | 38.5 ± 1.3 | Route: Intravenous; Frequency: Increased by 2 mU/min every 20 min; Rate: Starting at 2 mU/min | |||
Ahmed, 2023 | Egypt | Misoprostol | 85 | 25.6 ± 4.1 | 37.9 ± 1.5 | Route: Oral; Frequency: Every 4 h; Dose: 25 ug per dose (maximum 125 ug) | 1, 2, 4, 5, 6, 8, 10, 12, 14 |
Oxytocin | 85 | 25.0 ± 3.7 | 38.1 ± 1.4 | Route: Intravenous; Frequency: Raised by 2 mL/hour every half-hour; Rate: Start at 1 mL/hour (1 mIU/min) for half-hour, then shift to 2 mL/h for half-hour, maximum: 27 mL/h | |||
Kumari, 2023 | India | Misoprostol | 50 | NR | > 36 | Route: Vaginal; Frequency: Every four hours; Dose: 50 ug per dose (maximum 150 ug) | 5 |
Oxytocin | 50 | NR | > 36 | Route: Intravenous; Frequency: Accelerated until adequate contractions; Rate: Starting with 2 units in 500 mL of Ringer Lactate at 8 drops per minute, maximum: 22 mU per minute for multigravida and 40 mU per minute for primigravida | |||
Bender, 2024 | USA | Misoprostol | 52 | 30.0 ± 5.4 | 39.7 ± 1.2 | Route: Oral; Frequency: Every 4 h; Dose: 50 ug per dose (maximum 300 ug) | 2, 5, 8, 17 |
Oxytocin | 56 | 28.5 ± 5.9 | 39.3 ± 1.3 | Route: Intravenous; Frequency: Increased by 2 mU every 15 min; Rate: Starting at 2 milliunits (mU)/min, maximum 40 mU |