Comparison 9.
Vaginal isosorbide mononitrate (IMN) versus placebo
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
|---|---|---|---|---|
| 1 Vaginal delivery not achieved in 24/48 hrs | 1 | 238 | Risk Ratio (M-H, Fixed, 95% CI) | 0.97 [0.83, 1.15] |
| 2 Additional induction agents required | 3 | 559 | Risk Ratio (M-H, Fixed, 95% CI) | 0.83 [0.74, 0.92] |
| 3 Serious maternal morbidity or death | 0 | 0 | Risk Ratio (M-H, Fixed, 95% CI) | Not estimable |
| 4 Maternal satisfaction (women would recommend procedure) | 1 | 193 | Risk Ratio (M-H, Fixed, 95% CI) | 1.01 [0.94, 1.08] |
| 5 Maternal satisfaction (various questions, low score= satisfied, high score = dissatisfied, score out of 10) | 1 | Mean Difference (IV, Fixed, 95% CI) | Subtotals only | |
| 5.1 How do you think your labour went? (easy/very difficult) | 1 | 227 | Mean Difference (IV, Fixed, 95% CI) | −0.34 [−0.94, 0.26] |
| 5.2 What do you think about home treatment? (extremely good/not at all good) | 1 | 227 | Mean Difference (IV, Fixed, 95% CI) | 0.61 [0.03, 1.19] |
| 5.3 How painful was the treatment at home? (not at all/very) | 1 | 227 | Mean Difference (IV, Fixed, 95% CI) | 0.58 [−0.00, 1.16] |
| 5.4 How anxious were you being at home taking the treatment? (not at all/very) | 1 | 227 | Mean Difference (IV, Fixed, 95% CI) | 0.11 [−0.39, 0.61] |
| 5.5 Would you have the same treatment at home again? (definitely/definitely not) | 1 | 227 | Mean Difference (IV, Fixed, 95% CI) | 0.62 [−0.02, 1.26] |
| 5.6 Would you advise a friend to have the same treatment at home? (definitely/definitely not) | 1 | 227 | Mean Difference (IV, Fixed, 95% CI) | 0.41 [−0.17, 0.99] |
| 6 Postpartum haemorrhage (> 500 ml) | 3 | 256 | Risk Ratio (M-H, Fixed, 95% CI) | 1.19 [0.89, 1.59] |
| 7 Caesarean section | 3 | 652 | Risk Ratio (M-H, Fixed, 95% CI) | 1.03 [0.81, 1.31] |
| 8 Assisted (instrumental) vaginal delivery | 1 | 350 | Risk Ratio (M-H, Fixed, 95% CI) | 0.85 [0.61, 1.18] |
| 9 Oxytocin augmentation | 1 | 254 | Risk Ratio (M-H, Fixed, 95% CI) | 1.07 [0.88, 1.30] |
| 10 Epidural | 1 | 350 | Risk Ratio (M-H, Fixed, 95% CI) | 0.94 [0.82, 1.09] |
| 11 Cervix unchanged after 48 hrs | 1 | 257 | Risk Ratio (M-H, Fixed, 95% CI) | 0.83 [0.70, 0.97] |
| 12 Maternal side effect - headache | 3 | 522 | Risk Ratio (M-H, Fixed, 95% CI) | 5.41 [3.85, 7.60] |
| 13 Maternal side effect - nausea | 2 | 420 | Risk Ratio (M-H, Fixed, 95% CI) | 2.06 [1.22, 3.50] |
| 14 Admitted in established labour within 24 hours | 1 | 200 | Risk Ratio (M-H, Fixed, 95% CI) | 2.75 [1.29, 5.88] |
| 15 Uterine hyperstimulation (with FHR changes) | 1 | 102 | Risk Ratio (M-H, Fixed, 95% CI) | 0.2 [0.01, 4.07] |
| 16 Side effects: severe headache | 1 | 220 | Risk Ratio (M-H, Fixed, 95% CI) | 21.21 [2.91, 154.65] |
| 17 Total cost of care package (GB £) | 1 | 350 | Mean Difference (IV, Fixed, 95% CI) | 11.98 [−105.34, 129.30] |
| 18 Perinatal death | 1 | 350 | Risk Ratio (M-H, Fixed, 95% CI) | 0.33 [0.01, 7.94] |
| 19 Apgar score < 7 at 5 minutes 3 | 3 | 256 | Risk Ratio (M-H, Fixed, 95% CI) | 1.21 [0.35, 4.17] |
| 20 NICU admission | 3 | 652 | Risk Ratio (M-H, Fixed, 95% CI) | 1.17 [0.72, 1.92] |
| 21 Interval from admission to vaginal delivery (hours) | 1 | 128 | Mean Difference (IV, Fixed, 95% CI) | −0.70 [−6.11, 4.71] |
| 22 Neonatal infection | 1 | 200 | Risk Ratio (M-H, Fixed, 95% CI) | 1.0 [0.26, 3.89] |
| 23 Bishop score > 6 or active labour at 36 hours | 1 | 102 | Risk Ratio (M-H, Fixed, 95% CI) | 3.8 [1.54, 9.40] |
| 24 Time in hours from admission to delivery (all women) | 1 | 102 | Mean Difference (IV, Fixed, 95% CI) | −6.67 [−9.56, −3.78] |
| 25 Onset of labour within 24 hours | 1 | 200 | Risk Ratio (M-H, Fixed, 95% CI) | 2.75 [1.29, 5.88] |