Qamar 2012.
| Methods | Quasi‐experimental | |
| Participants | Inclusion: singleton alive fetus, cephalic presentation, gestation at or beyond 37 weeks, para 4 or less, BS less than 5, obstetric and medical indication for induction Exclusion: congenital anomalies, multiple pregnancies, mal‐presentation, CPD, placenta praevia or APH, previous CS, and PROM |
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| Interventions | PGE2 pessary (80) dosage not known, failure of improvement of modified BS after 6 hours (< 5), a second PG E2 gel/pessary was applied and patient reassessed again after 6 hours. If still there was no improvement in BS (< 5) a 3rd PG E2 gel/pessary was applied. PGE2 intracervical (80): as above EASI with oxytocin IV (80) Foleys catheter of 24 or 26 Fr, inflated with 45 mL of distilled water. Traction applied and then saline infusion was started extra‐amniotically at 30 mL per hour for 12 hours. oxytocin infusion was started at 2 mU/minute and the dose was doubled at half‐hourly interval up to the max dose of 40 mU/minute |
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| Outcomes | induction labour interval, induction delivery interval, mode of delivery, AS at 1 and 5 minutes, and neonatal morbidity and mortality including ICU admission. | |
| Notes | No relevant outcomes reported in article Setting: Pakistan Study period: not reported Funding: not reported Declarations of interest: not reported |
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| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | High risk | Allocation in order of admission |
| Allocation concealment (selection bias) | High risk | Method of induction could be foreseen as a rotation was used |
| Blinding of participants and personnel (performance bias) All outcomes | Unclear risk | Not feasible due to nature of intervention |
| Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Not reported |
| Incomplete outcome data (attrition bias) All outcomes | Unclear risk | Unclear if ITT was used, missing cases or outcomes not reported |
| Selective reporting (reporting bias) | High risk | Neonatal mortality not reported in numbers, only reported they dit not differ. neonatal morbidity not reported in results |
| Other bias | Low risk | No other bias detected |