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. Author manuscript; available in PMC: 2014 Jun 3.
Published in final edited form as: Cochrane Database Syst Rev. 2010 Jan 20;(1):CD007223. doi: 10.1002/14651858.CD007223.pub2

Comparison 2.

Misoprostol versus surgery

Outcome or subgroup title No. of studies No. of participants Statistical method Effect size
1 Complete miscarriage 8 1377 Risk Ratio (M-H, Random, 95% CI) 0.96 [0.92, 1.00]
 1.1 Vaginal misoprostol 3 154 Risk Ratio (M-H, Random, 95% CI) 0.91 [0.83, 0.99]
 1.2 Oral misoprostol 4 1143 Risk Ratio (M-H, Random, 95% CI) 0.97 [0.93, 1.02]
 1.3 Vaginal + oral misoprostol 1 80 Risk Ratio (M-H, Random, 95% CI) 0.95 [0.87, 1.04]
 1.4 Rectal misoprostol 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
 1.5 Sublingual misoprostol 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
2 Surgical evacuation 8 1538 Risk Ratio (M-H, Random, 95% CI) 0.07 [0.03, 0.18]
 2.1 Vaginal misoprostol 3 315 Risk Ratio (M-H, Random, 95% CI) 0.18 [0.08, 0.44]
 2.2 Oral misoprostol 4 1143 Risk Ratio (M-H, Random, 95% CI) 0.05 [0.02, 0.10]
 2.3 Vaginal + oral misoprostol 1 80 Risk Ratio (M-H, Random, 95% CI) 0.04 [0.01, 0.18]
 2.4 Rectal misoprostol 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
 2.5 Sublingual misoprostol 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
3 Death or serious complication 2 132 Risk Ratio (M-H, Random, 95% CI) 1.0 [0.04, 22.64]
 3.1 Vaginal misoprostol 2 132 Risk Ratio (M-H, Random, 95% CI) 1.0 [0.04, 22.64]
 3.2 Oral misoprostol 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
 3.3 Vaginal + oral misoprostol 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
 3.4 Rectal misoprostol 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
 3.5 Sublingual misoprostol 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
4 Unplanned surgical intervention 6 1158 Risk Ratio (M-H, Random, 95% CI) 6.32 [2.90, 13.77]
 4.1 Vaginal misoprostol 3 315 Risk Ratio (M-H, Random, 95% CI) 5.56 [1.11, 27.90]
 4.2 Oral misoprostol 3 843 Risk Ratio (M-H, Random, 95% CI) 6.12 [1.99, 18.84]
 4.3 Vaginal + oral misoprostol 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
 4.4 Rectal misoprostol 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
 4.5 Sublingual misoprostol 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
5 Blood transfusion 4 430 Risk Ratio (M-H, Random, 95% CI) 1.73 [0.19, 16.08]
 5.1 Vaginal misoprostol 3 241 Risk Ratio (M-H, Random, 95% CI) 1.73 [0.19, 16.08]
 5.2 Oral misoprostol 1 189 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
 5.3 Vaginal + oral misoprostol 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
 5.4 Rectal misoprostol 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
 5.5 Sublingual misoprostol 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
6 Haemorrhage 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
 6.1 Vaginal misoprostol 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
 6.2 Oral misoprostol 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
 6.3 Vaginal + oral misoprostol 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
 6.4 Rectal misoprostol 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
 6.5 Sublingual misoprostol 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
7 Blood loss 0 0 Mean Difference (IV, Random, 95% CI) 0.0 [0.0, 0.0]
 7.1 Vaginal misoprostol 0 0 Mean Difference (IV, Random, 95% CI) 0.0 [0.0, 0.0]
 7.2 Oral misoprostol 0 0 Mean Difference (IV, Random, 95% CI) 0.0 [0.0, 0.0]
 7.3 Vaginal + oral misoprostol 0 0 Mean Difference (IV, Random, 95% CI) 0.0 [0.0, 0.0]
 7.4 Rectal misoprostol 0 0 Mean Difference (IV, Random, 95% CI) 0.0 [0.0, 0.0]
 7.5 Sublingual misoprostol 0 0 Mean Difference (IV, Random, 95% CI) 0.0 [0.0, 0.0]
8 Anaemia 1 36 Risk Ratio (M-H, Random, 95% CI) 1.71 [0.24, 12.24]
 8.1 Vaginal misoprostol 1 36 Risk Ratio (M-H, Random, 95% CI) 1.71 [0.24, 12.24]
 8.2 Oral misoprostol 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
 8.3 Vaginal + oral misoprostol 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
 8.4 Rectal misoprostol 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
 8.5 Sublingual misoprostol 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
9 Days of bleeding 3 211 Mean Difference (IV, Random, 95% CI) 2.12 [1.18, 3.07]
 9.1 Vaginal misoprostol 2 131 Mean Difference (IV, Random, 95% CI) 2.76 [1.55, 3.97]
 9.2 Oral misoprostol 0 0 Mean Difference (IV, Random, 95% CI) 0.0 [0.0, 0.0]
 9.3 Vaginal + oral misoprostol 1 80 Mean Difference (IV, Random, 95% CI) 1.55 [0.58, 2.52]
 9.4 Rectal misoprostol 0 0 Mean Difference (IV, Random, 95% CI) 0.0 [0.0, 0.0]
 9.5 Sublingual misoprostol 0 0 Mean Difference (IV, Random, 95% CI) 0.0 [0.0, 0.0]
10 Pain relief 4 525 Risk Ratio (M-H, Random, 95% CI) 1.48 [0.67, 3.25]
 10.1 Vaginal misoprostol 3 313 Risk Ratio (M-H, Random, 95% CI) 1.64 [1.05, 2.55]
 10.2 Oral misoprostol 1 212 Risk Ratio (M-H, Random, 95% CI) 0.85 [0.77, 0.92]
 10.3 Vaginal + oral misoprostol 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
 10.4 Rectal misoprostol 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
 10.5 Sublingual misoprostol 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
11 Pelvic infection < 14 days 7 907 Risk Ratio (M-H, Random, 95% CI) 0.70 [0.25, 1.99]
 11.1 Vaginal misoprostol 4 338 Risk Ratio (M-H, Random, 95% CI) 1.14 [0.29, 4.44]
 11.2 Oral misoprostol 2 489 Risk Ratio (M-H, Random, 95% CI) 0.26 [0.03, 2.41]
 11.3 Vaginal + oral misoprostol 1 80 Risk Ratio (M-H, Random, 95% CI) 0.5 [0.05, 5.30]
 11.4 Rectal misoprostol 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
 11.5 Sublingual misoprostol 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
12 Cervical damage 1 189 Risk Ratio (M-H, Random, 95% CI) 0.07 [0.00, 1.25]
 12.1 Vaginal misoprostol 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
 12.2 Oral misoprostol 1 189 Risk Ratio (M-H, Random, 95% CI) 0.07 [0.00, 1.25]
 12.3 Vaginal + oral misoprostol 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
 12.4 Rectal misoprostol 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
 12.5 Sublingual misoprostol 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
13 Digestive disorders 0 0 Risk Ratio (M-H, Fixed, 95% CI) 0.0 [0.0, 0.0]
 13.1 Vaginal misoprostol 0 0 Risk Ratio (M-H, Fixed, 95% CI) 0.0 [0.0, 0.0]
 13.2 Oral misoprostol 0 0 Risk Ratio (M-H, Fixed, 95% CI) 0.0 [0.0, 0.0]
 13.3 Vaginal + oral misoprostol 0 0 Risk Ratio (M-H, Fixed, 95% CI) 0.0 [0.0, 0.0]
 13.4 Rectal misoprostol 0 0 Risk Ratio (M-H, Fixed, 95% CI) 0.0 [0.0, 0.0]
 13.5 Sublingual misoprostol 0 0 Risk Ratio (M-H, Fixed, 95% CI) 0.0 [0.0, 0.0]
14 Hypertensive disorders 0 0 Risk Ratio (M-H, Fixed, 95% CI) 0.0 [0.0, 0.0]
 14.1 Vaginal misoprostol 0 0 Risk Ratio (M-H, Fixed, 95% CI) 0.0 [0.0, 0.0]
 14.2 Oral misoprostol 0 0 Risk Ratio (M-H, Fixed, 95% CI) 0.0 [0.0, 0.0]
 14.3 Vaginal + oral misoprostol 0 0 Risk Ratio (M-H, Fixed, 95% CI) 0.0 [0.0, 0.0]
 14.4 Rectal misoprostol 0 0 Risk Ratio (M-H, Fixed, 95% CI) 0.0 [0.0, 0.0]
 14.5 Sublingual misoprostol 0 0 Risk Ratio (M-H, Fixed, 95% CI) 0.0 [0.0, 0.0]
15 Duration of hospital stay 0 0 Mean Difference (IV, Fixed, 95% CI) 0.0 [0.0, 0.0]
 15.1 Vaginal misoprostol 0 0 Mean Difference (IV, Fixed, 95% CI) 0.0 [0.0, 0.0]
 15.2 Oral misoprostol 0 0 Mean Difference (IV, Fixed, 95% CI) 0.0 [0.0, 0.0]
 15.3 Vaginal + oral misoprostol 0 0 Mean Difference (IV, Fixed, 95% CI) 0.0 [0.0, 0.0]
 15.4 Rectal misoprostol 0 0 Mean Difference (IV, Fixed, 95% CI) 0.0 [0.0, 0.0]
 15.5 Sublingual misoprostol 0 0 Mean Difference (IV, Fixed, 95% CI) 0.0 [0.0, 0.0]
16 Psychological effects 0 0 Mean Difference (IV, Fixed, 95% CI) 0.0 [0.0, 0.0]
 16.1 Vaginal misoprostol 0 0 Mean Difference (IV, Fixed, 95% CI) 0.0 [0.0, 0.0]
 16.2 Oral misoprostol 0 0 Mean Difference (IV, Fixed, 95% CI) 0.0 [0.0, 0.0]
 16.3 Vaginal + oral misoprostol 0 0 Mean Difference (IV, Fixed, 95% CI) 0.0 [0.0, 0.0]
 16.4 Rectal misoprostol 0 0 Mean Difference (IV, Fixed, 95% CI) 0.0 [0.0, 0.0]
 16.5 Sublingual misoprostol 0 0 Mean Difference (IV, Fixed, 95% CI) 0.0 [0.0, 0.0]
17 Subsequent fertility 0 0 Risk Ratio (M-H, Fixed, 95% CI) 0.0 [0.0, 0.0]
 17.1 Vaginal misoprostol 0 0 Risk Ratio (M-H, Fixed, 95% CI) 0.0 [0.0, 0.0]
 17.2 Oral misoprostol 0 0 Risk Ratio (M-H, Fixed, 95% CI) 0.0 [0.0, 0.0]
 17.3 Vaginal + oral misoprostol 0 0 Risk Ratio (M-H, Fixed, 95% CI) 0.0 [0.0, 0.0]
 17.4 Rectal misoprostol 0 0 Risk Ratio (M-H, Fixed, 95% CI) 0.0 [0.0, 0.0]
 17.5 Sublingual misoprostol 0 0 Risk Ratio (M-H, Fixed, 95% CI) 0.0 [0.0, 0.0]
18 Women’s views/satisfaction 4 1134 Risk Ratio (M-H, Random, 95% CI) 0.99 [0.98, 1.01]
 18.1 Vaginal misoprostol 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
 18.2 Oral misoprostol 4 1134 Risk Ratio (M-H, Random, 95% CI) 0.99 [0.98, 1.01]
 18.3 Vaginal + oral misoprostol 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
 18.4 Rectal misoprostol 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
 18.5 Sublingual misoprostol 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
19 Women’s views/satisfaction - continuous data 2 131 Std. Mean Difference (IV, Random, 95% CI) 1.01 [0.01, 2.00]
 19.1 Vaginal misoprostol 2 131 Std. Mean Difference (IV, Random, 95% CI) 1.01 [0.01, 2.00]
 19.2 Oral misoprostol 0 0 Std. Mean Difference (IV, Random, 95% CI) 0.0 [0.0, 0.0]
 19.3 Vaginal + oral misoprostol 0 0 Std. Mean Difference (IV, Random, 95% CI) 0.0 [0.0, 0.0]
 19.4 Rectal misoprostol 0 0 Std. Mean Difference (IV, Random, 95% CI) 0.0 [0.0, 0.0]
 19.5 Sublingual misoprostol 0 0 Std. Mean Difference (IV, Random, 95% CI) 0.0 [0.0, 0.0]
20 Death 1 38 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
 20.1 Vaginal misoprostol 1 38 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
 20.2 Oral misoprostol 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
 20.3 Vaginal + oral misoprostol 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
 20.4 Rectal misoprostol 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
 20.5 Sublingual misoprostol 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
21 Serious morbidity 1 94 Risk Ratio (M-H, Fixed, 95% CI) 0.0 [0.0, 0.0]
 21.1 Vaginal misoprostol 1 94 Risk Ratio (M-H, Fixed, 95% CI) 0.0 [0.0, 0.0]
 21.2 Oral misoprostol 0 0 Risk Ratio (M-H, Fixed, 95% CI) 0.0 [0.0, 0.0]
 21.3 Vaginal + oral misoprostol 0 0 Risk Ratio (M-H, Fixed, 95% CI) 0.0 [0.0, 0.0]
 21.4 Rectal misoprostol 0 0 Risk Ratio (M-H, Fixed, 95% CI) 0.0 [0.0, 0.0]
 21.5 Sublingual misoprostol 0 0 Risk Ratio (M-H, Fixed, 95% CI) 0.0 [0.0, 0.0]
22 Pathology of placental tissue 0 0 Mean Difference (IV, Fixed, 95% CI) 0.0 [0.0, 0.0]
 22.1 Vaginal misoprostol 0 0 Mean Difference (IV, Fixed, 95% CI) 0.0 [0.0, 0.0]
 22.2 Oral misoprostol 0 0 Mean Difference (IV, Fixed, 95% CI) 0.0 [0.0, 0.0]
 22.3 Vaginal + oral misoprostol 0 0 Mean Difference (IV, Fixed, 95% CI) 0.0 [0.0, 0.0]
 22.4 Rectal misoprostol 0 0 Mean Difference (IV, Fixed, 95% CI) 0.0 [0.0, 0.0]
 22.5 Sublingual misoprostol 0 0 Mean Difference (IV, Fixed, 95% CI) 0.0 [0.0, 0.0]
23 Costs 0 0 Mean Difference (IV, Fixed, 95% CI) 0.0 [0.0, 0.0]
 23.1 Vaginal misoprostol 0 0 Mean Difference (IV, Fixed, 95% CI) 0.0 [0.0, 0.0]
 23.2 Oral misoprostol 0 0 Mean Difference (IV, Fixed, 95% CI) 0.0 [0.0, 0.0]
 23.3 Vaginal + oral misoprostol 0 0 Mean Difference (IV, Fixed, 95% CI) 0.0 [0.0, 0.0]
 23.4 Rectal misoprostol 0 0 Mean Difference (IV, Fixed, 95% CI) 0.0 [0.0, 0.0]
 23.5 Sublingual misoprostol 0 0 Mean Difference (IV, Fixed, 95% CI) 0.0 [0.0, 0.0]
24 Nausea 6 1115 Risk Ratio (M-H, Random, 95% CI) 3.18 [1.78, 5.70]
 24.1 Vaginal misoprostol 3 156 Risk Ratio (M-H, Random, 95% CI) 1.46 [0.61, 3.48]
 24.2 Oral misoprostol 3 959 Risk Ratio (M-H, Random, 95% CI) 4.69 [2.64, 8.34]
 24.3 Vaginal + oral misoprostol 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
 24.4 Rectal misoprostol 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
 24.5 Sublingual misoprostol 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
25 Vomiting 5 1090 Risk Ratio (M-H, Random, 95% CI) 2.25 [1.14, 4.43]
 25.1 Vaginal misoprostol 2 131 Risk Ratio (M-H, Random, 95% CI) 1.26 [0.12, 13.73]
 25.2 Oral misoprostol 3 959 Risk Ratio (M-H, Random, 95% CI) 2.39 [1.13, 5.02]
 25.3 Vaginal + oral misoprostol 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
 25.4 Rectal misoprostol 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
 25.5 Sublingual misoprostol 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
26 Diarrhoea 3 437 Risk Ratio (M-H, Random, 95% CI) 4.25 [0.76, 23.73]
 26.1 Vaginal misoprostol 2 131 Risk Ratio (M-H, Random, 95% CI) 4.09 [0.51, 32.97]
 26.2 Oral misoprostol 1 306 Risk Ratio (M-H, Random, 95% CI) 4.63 [0.22, 95.55]
 26.3 Vaginal + oral misoprostol 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
 26.4 Rectal misoprostol 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
 26.5 Sublingual misoprostol 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]