Familiari A, Khalil A, Rizzo G, et al. - Researchers aimed to report on the outcome of pregnancies with small baby, incorporating both small for gestational age (SGA) and late fetal growth restriction (FGR) fetuses, undergoing induction of labor (IOL) with Dinoprostone, Misoprostol or mechanical methods. Medline, Embase and Cochrane databases yielded 12 studies (1,711 pregnancies) for inclusion. In the overall population of small fetuses, 21.2% of pregnancies induced with Dinoprostone, 18.0% of those with Misoprostol and 11.6% of those undergoing IOL with mechanical methods had occurrence of composite adverse intra-partum outcome. For non-reassuring fetal status (NRFS), cesarean section (CS) was performed in 18.1% of pregnancies induced with Dinoprostone, 9.4% of those with Misoprostol and 8.1% of those undergoing mechanical induction. Similarly, CTG showed uterine tachysystole in 13.8% of cases induced with Dinoprostone, 7.5% of those with Misoprostol and 3.8% of those induced with mechanical methods. Composite adverse perinatal outcome following delivery complicated 2.9% newborns after IOL with Dinoprostone, 0.6% with Misoprostol and 0.7% with mechanical methods. In pregnancies complicated by late FGR, 25.3% of women undergoing IOL with Dinoprostone had adverse intrapartum outcome, compared with 7.4% of those with mechanical methods, while 23.8% and 6.2% of the cases, respectively, required CS for NRFS, respectively. Finally, in SGA fetuses, complications were reported in correlation with composite adverse intrapartum outcome in 8.4% of pregnancies induced with Dinoprostone, 18.6% of those with Misoprostol and 8.7 of those undergoing mechanical IOL, while 8.4% of women induced with Dinoprostone, 18.6% of those with Misoprostol and 8.7% of those undergoing mechanical induction required CS for NRF. Limited evidence was thus gained on the optimal type of IOL in pregnancies with small fetuses. This study suggests a possible correlation of mechanical methods with a lower occurrence of adverse intrapartum outcomes.