Outpatient versus Inpatient Cervical Ripening for Labor Induction: A Systematic Review

Abstract

Introduction: For women requiring labor induction with an unfavorable cervix, cervical ripening is often necessary. This can be done in an inpatient or outpatient setting. This review compares the safety and efficacy of these two approaches.

Methods: We conducted a search of RCTs comparing outpatient (e.g., with a Foley catheter or prostaglandins) to inpatient cervical ripening. The primary outcomes were time to delivery and cesarean delivery rates.

Results: The meta-analysis of 15 RCTs showed no significant difference in the rates of cesarean delivery, time to delivery, or measures of neonatal morbidity between outpatient and inpatient cervical ripening. Outpatient management was associated with higher patient satisfaction and significant cost savings.

Discussion: For appropriately selected low-risk women, outpatient cervical ripening is a safe and effective alternative to inpatient management. It allows the woman to spend the early, latent phase of labor in the comfort of her own home.

Conclusion: Outpatient cervical ripening is a safe, effective, and cost-effective option for labor induction in low-risk women.