Outcomes of Outpatient Versus Inpatient Induction of Labor: A Systematic Review and Meta-Analysis

Induction of labor (IOL) has become a common practice in obstetrics, leading to an increase in antenatal admissions and workload. This review aims to explore the available options for outpatient IOL and their effectiveness. We conducted an electronic search for trials on Cochrane, PubMed, Google Scholar, and Web of Science databases for randomized control trials (RCTs) comparing inpatient and outpatient labor induction and covering the period until 2024. We selected randomized trials that compared IOL in outpatient vs. inpatient settings and involved mechanical or hormonal agents. The participants were pregnant women with singleton fetuses who were more than 37 weeks and low risk for IOL with a Bishop score <6. When comparing outpatient and inpatient induction methods, we found no significant differences in cesarean section rates and vaginal delivery. Outpatient induction generally resulted in shorter hospital stays. Using a Foley catheter for outpatient induction reduced the cesarean section rate and total hospital stay. There were no safety concerns with this approach. IOL in this analysis was shown to be similar to inpatient IOL in most of the measured outcomes. Implementation of IOL in an outpatient setting proved to be safe with similar outcomes to inpatient IOL.