BMJ 2012; 344 doi: https://doi.org/10.1136/bmj.e52 (Published 12 January 2012) Cite this as: BMJ 2012;344:e52

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The success of labour induction at term depends partly on the ripeness of the cervix (European Journal of Obstetrics and Gynecology and Reproductive Biology 2011;159:315-9, doi:10.1016/j.ejogrb.2011.09.010). A German randomised controlled trial of 122 women using oral misoprostol (off label) and mechanical cervical dilatation with a double balloon catheter for cervical ripening, compared with oral misoprostol alone, found the combined method group had a significantly lower rate of failure to induce labour than the controls (9% versus 21%, P=0.007). The median time for inducing labour was 15.3 hours in the active group and 20.8 hours in the control group (P=0.002).

Two distinct elements are …

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