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Volume 16, Issue 1 (4-2026)
cmja 2026, 16(1): 0-0 |
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Aghaei meybodi F, ghazanfarian Meybodi A. Cost-effectiveness analysis of mechanical methods for inducing vaginal labor, compared to pharmacological methods, specifically oxytocin and misoprostol: a systematic review. cmja 2026; 16 (1)
URL: http://cmja.arakmu.ac.ir/article-1-1095-en.html
URL: http://cmja.arakmu.ac.ir/article-1-1095-en.html
1- Department of Midwifery, Meybod Branch, Islamic Azad University, Meybod, Iran. & Instructor, Ph.D. Student in Reproductive Health, Department of Midwifery and Reproductive Health, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Iran. , aghaeimf@nm.mui.ac.ir
2- Midwife, Yazd University of Medical Sciences, Meybod Hospital, Meybod, Iran.
2- Midwife, Yazd University of Medical Sciences, Meybod Hospital, Meybod, Iran.
Abstract: (101 Views)
Background and Aims: Labor induction, a common intervention in 20–30% of pregnancies, necessitates the selection of an optimal method to impact clinical outcomes and healthcare system costs. Pharmacological methods (e.g., misoprostol and oxytocin) and mechanical methods (e.g., Foley catheter and hygroscopic dilators) each possess distinct advantages and limitations. Given the escalating economic burden on healthcare systems, a cost-effectiveness analysis of these methods has become crucial.
Methods: A systematic review, adhering to PRISMA guidelines and searching prominent databases (PubMed, Scopus, Embase, Cochrane Library) from 2015–2025, identified 12 eligible studies, including randomized controlled trials and economic evaluations.
Results: Findings indicated that mechanical methods, particularly the Foley catheter usage, demonstrated comparable efficacy to misoprostol consumption and were associated with lower costs in numerous analyses, especially in outpatient settings. Misoprostol was also found to be more cost-effective in some studies due to its low price and efficacy in specific populations. Heterogeneity in results was primarily attributed to variations in patient characteristics, induction protocols, and healthcare system structures.
Conclusion: No single method proved universally superior; selection should be tailored to patient characteristics, available resources, and national healthcare policies. Mechanical methods in outpatient settings may offer substantial economic benefits, while misoprostol remains an attractive low-cost option. Large-scale, multicenter randomized controlled trials with robust sensitivity analyses are recommended to strengthen the evidence base for clinical and policy decision-making.
Methods: A systematic review, adhering to PRISMA guidelines and searching prominent databases (PubMed, Scopus, Embase, Cochrane Library) from 2015–2025, identified 12 eligible studies, including randomized controlled trials and economic evaluations.
Results: Findings indicated that mechanical methods, particularly the Foley catheter usage, demonstrated comparable efficacy to misoprostol consumption and were associated with lower costs in numerous analyses, especially in outpatient settings. Misoprostol was also found to be more cost-effective in some studies due to its low price and efficacy in specific populations. Heterogeneity in results was primarily attributed to variations in patient characteristics, induction protocols, and healthcare system structures.
Conclusion: No single method proved universally superior; selection should be tailored to patient characteristics, available resources, and national healthcare policies. Mechanical methods in outpatient settings may offer substantial economic benefits, while misoprostol remains an attractive low-cost option. Large-scale, multicenter randomized controlled trials with robust sensitivity analyses are recommended to strengthen the evidence base for clinical and policy decision-making.
Keywords: Labor induction, Foley catheter, Misoprostol, Cost-effectiveness, Economic evaluation, cost management
Type of Study: Review Paper |
Subject:
Nursing and Midwifery
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Complementary Medicine Journal
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