Effect of dexamethasone on labour induction and cervical ripening in term pregnancies: a systematic review and meta-analysis

Abstract

This study assessed the effect of dexamethasone on labour induction, Bishop Score, mean intervals from induction of labour to the active phase and delivery, duration of first and second stages of labour and caesarean section frequency. A search was carried out in PubMed, Cochrane Library, Embase, Ovid, Scopus, ClinicalTrials.gov, Google Scholar and Persian databases. The quality of studies was evaluated using Cochrane handbook and the meta-analysis was conducted in RevMan 5.3. The heterogeneity of the studies was assessed using I 2, T 2 and Chi 2. Subgroup analysis was used based on the routes of drug administration. Quality of evidence was assessed using the GRADE approach. 10 studies were included. The results showed significant differences between dexamethasone and control groups in terms of the mean interval from induction of labour to the active phase (MD = −1.55), Bishop score (MD = 2.40), duration of second stage of labour (MD = −8.61) and interval from induction of labour to delivery (MD = −2.83). There were no significant differences in duration of first stage of labour (MD= −0.69) and caesarean section frequency (RR = 1.09). Dexamethasone reduces the time interval between induction and delivery and also accelerates labour through cervical ripening and Bishop Score improvements. IMPACT STATEMENT What is already known on this subject? Labour induction is a common obstetrics procedure. The desirable condition of the cervix, measured by the Bishop score, is a key to the successful induction. Several mechanical and biomechanical methods are used to achieve desirable cervical ripeness. The role of corticosteroids in the delivery process has not been well demonstrated. What do the results of this study add? The meta-analysis results showed significant differences between dexamethasone and control groups in terms of the mean interval from induction of labour to the active phase. What are the implications of these findings for clinical practice and/or future research? According to the evidences, dexamethasone can be used to reduce the interval between induction to active phase.