Table 5.
Effect estimates and certainty of evidence for clinical interventions that influence uterine dehiscence rates
| Comparison | No. of studies | Comparison 1 (no. of women with uterine dehiscence/no. of women) | Comparison 2 (no. of women with uterine dehiscence/no. of women) | Risk Difference, M-H, Random (95% CI) | I2 (%) | Quality |
|---|---|---|---|---|---|---|
| Pharmacologic induction | ||||||
| PGE1 vs. spontaneous labor | Prospective cohort (2) | 5/117 | 6/357 | 0.02 (−0.06, 0.09) | 65 | Very Low |
| PGE2 vs. spontaneous labor | Prospective cohort (2) | 1/171 | 0/222 | 0.01 (−0.01, 0.02) | 0 | Very Low |
| Oxytocin vs. spontaneous labor |
Prospective cohort (3) Retrospective cohort (2) |
21/1113 | 16/2298 | 0.01 (0.00, 0.02) | 20 | Very Low |
| Mifepristone vs. placebo | RCT (1) | 1/16 | 1/16 | 0.00 (− 0.17, 0.17) | NA | Low |
| Epidural analgesia vs. no epidural | Retrospective cohort (1) | 4/87 | 1/150 | 0.04 (− 0.01, 0.09) | NA | Very Low |
| Oxytocin vs. PGE2 | Prospective cohort (1) | 1/208 | 1/146 | 0.00 (−0.02, 0.01) | NA | Very Low |
| Active inpatient management (+/− oxytocin) vs. expectant outpatient management (+/− oxytocin) | RCT (1) | 5/95 | 0/93 | 0.05 (0.00, 0.10) | NA | Very Low |
| Non-pharmacologic induction | ||||||
| Membrane sweep vs. spontaneous labor | RCT (1) | 0/62 | 1/61 | -0.02 (− 0.06, 0.03) | NA | Very Low |
| 30 mL Foley catheter vs. 80 mL Foley catheter | RCT (1) | 2/77 | 7/77 | −0.06 (− 0.14, 0.01) | NA | Low |
| Pharmacologic vs. Non-pharmacologic or Combined (pharmacologic + non-pharmacologic) | ||||||
| Oxytocin +/− amniotomy vs. amniotomy | Retrospective cohort (1) | 4/102 | 0/35 | 0.04 (− 0.02, 0.09) | NA | Very Low |
| Induction (PGE2, oxytocin, amniotomy and/or Foley catheter) vs. spontaneous labor | Retrospective cohort (1) | 13/1576 | 36/4263 | 0.00 (− 0.01, 0.01) | NA | Very Low |
| Induction (oxytocin, PGE2, misoprostol + oxytocin [augmentation]) vs. spontaneous labor | Retrospective cohort (1) | 4/57 | 3/179 | 0.05 (−0.02, 0.12) | NA | Very Low |
CI confidence interval, NA not applicable, NS not specified, no. number, PGE1/PGE2 prostaglandin 1/prostaglandin 2; RCT randomized clinical trial, VD vaginal delivery, vs. versus