Combination methods

Each method previously outlined has its strengths but due to the multitude of options available, various combinations of methods have been investigated over time. Balloon catheters have been used with prostaglandins in multiple different configurations. The overall conclusion from a meta-analysis is that this combination leads to a lower rate of hyperstimulation than when prostaglandins are used alone (38). Many studies also show a shorter time to vaginal delivery, but heterogeneity in the results prevent its recommendation for rou­tine use (38).