Abstract
PGEs are still accepted as standard of care for IOL in many settings despite the fact that there is good evidence from RCTs and meta-analysis confirming equivalent efficacy and better safety profile of mechanical methods. Mechanical methods are slower than PGEs in achieveing vaginal birth within 24 h but equivalent at 36 and 48 h.
Along safety benefits compared to PGs, mechanical methods can also offer time and health care budget savings (no need of repeated CTGs and/or vaginal examinations during ripening period), and are more suitable for home outpatient cervical ripening. Compared to balloon catheters, synthetic hygroscopic cervical dilators offer equal efficacy and safety profile but better maternal compliance and satisfaction.