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. 2012 Aug 15;2012(8):CD000494. doi: 10.1002/14651858.CD000494.pub4

Comparison 6. Rectal misoprostol versus injectable uterotonics (subgroups by dose).

Outcome or subgroup title No. of studies No. of participants Statistical method Effect size
1 Maternal death 3 1393 Risk Ratio (M‐H, Fixed, 95% CI) 0.34 [0.01, 8.21]
1.1 800 mcg 1 450 Risk Ratio (M‐H, Fixed, 95% CI) 0.34 [0.01, 8.21]
1.2 600 mcg 0 0 Risk Ratio (M‐H, Fixed, 95% CI) 0.0 [0.0, 0.0]
1.3 400 mcg 2 943 Risk Ratio (M‐H, Fixed, 95% CI) 0.0 [0.0, 0.0]
2 Postpartum haemorrhage (>= 500 mL) 7 3399 Risk Ratio (M‐H, Fixed, 95% CI) 1.15 [0.93, 1.41]
2.1 800 mcg 2 955 Risk Ratio (M‐H, Fixed, 95% CI) 1.12 [0.60, 2.09]
2.2 600 mcg 1 200 Risk Ratio (M‐H, Fixed, 95% CI) 3.0 [0.12, 72.77]
2.3 400 mcg 4 2244 Risk Ratio (M‐H, Fixed, 95% CI) 1.14 [0.92, 1.43]
3 Severe postpartum haemorrhage (>= 1000 mL) 4 2221 Risk Ratio (M‐H, Fixed, 95% CI) 1.10 [0.69, 1.77]
3.1 800 mcg 1 441 Risk Ratio (M‐H, Fixed, 95% CI) 0.34 [0.01, 8.40]
3.2 600 mcg 0 0 Risk Ratio (M‐H, Fixed, 95% CI) 0.0 [0.0, 0.0]
3.3 400 mcg 3 1780 Risk Ratio (M‐H, Fixed, 95% CI) 1.14 [0.70, 1.85]
4 Blood loss (mL) 6   Mean Difference (IV, Fixed, 95% CI) Totals not selected
4.1 800 mcg 1   Mean Difference (IV, Fixed, 95% CI) 0.0 [0.0, 0.0]
4.2 600 mcg 1   Mean Difference (IV, Fixed, 95% CI) 0.0 [0.0, 0.0]
4.3 400 mcg 4   Mean Difference (IV, Fixed, 95% CI) 0.0 [0.0, 0.0]
5 Use of additional uterotonics 6   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
5.1 800 mcg 2 961 Risk Ratio (M‐H, Fixed, 95% CI) 0.65 [0.35, 1.24]
5.2 600 mcg 1 200 Risk Ratio (M‐H, Fixed, 95% CI) 5.0 [0.59, 42.04]
5.3 400 mcg 3 1210 Risk Ratio (M‐H, Fixed, 95% CI) 1.64 [1.16, 2.31]
6 Blood transfusion 7 3105 Risk Ratio (M‐H, Fixed, 95% CI) 1.02 [0.59, 1.77]
6.1 800 mcg 2 952 Risk Ratio (M‐H, Fixed, 95% CI) 1.01 [0.40, 2.52]
6.2 600 mcg 0 0 Risk Ratio (M‐H, Fixed, 95% CI) 0.0 [0.0, 0.0]
6.3 400 mcg 5 2153 Risk Ratio (M‐H, Fixed, 95% CI) 1.03 [0.52, 2.04]
7 Manual removal of placenta 3 563 Risk Ratio (M‐H, Fixed, 95% CI) 0.54 [0.17, 1.67]
7.1 600 mcg 1 200 Risk Ratio (M‐H, Fixed, 95% CI) 3.0 [0.32, 28.35]
7.2 400 mcg 2 363 Risk Ratio (M‐H, Fixed, 95% CI) 0.20 [0.04, 1.16]
8 Duration of third stage (minutes) 7 3245 Mean Difference (IV, Fixed, 95% CI) 0.20 [‐0.05, 0.46]
8.1 800 mcg 2 964 Mean Difference (IV, Fixed, 95% CI) 0.16 [‐0.25, 0.56]
8.2 600 mcg 1 200 Mean Difference (IV, Fixed, 95% CI) 0.0 [‐1.25, 1.25]
8.3 400 mcg 4 2081 Mean Difference (IV, Fixed, 95% CI) 0.25 [‐0.08, 0.58]
9 Third stage >= 30 minutes 1   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
9.1 600 mcg 0 0 Risk Ratio (M‐H, Fixed, 95% CI) 0.0 [0.0, 0.0]
9.2 400 mcg 1 803 Risk Ratio (M‐H, Fixed, 95% CI) 6.17 [1.39, 27.38]
10 Postpartum haemoglobin 2 954 Mean Difference (IV, Fixed, 95% CI) 0.0 [‐0.16, 0.16]
10.1 800 mcg 2 954 Mean Difference (IV, Fixed, 95% CI) 0.0 [‐0.16, 0.16]
11 Nausea 5   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
11.1 800 mcg 2 942 Risk Ratio (M‐H, Fixed, 95% CI) 0.40 [0.08, 2.08]
11.2 600 mcg 1 200 Risk Ratio (M‐H, Fixed, 95% CI) 5.0 [0.24, 102.85]
11.3 400 mcg 2 355 Risk Ratio (M‐H, Fixed, 95% CI) 1.04 [0.41, 2.61]
12 Vomiting 6 2759 Risk Ratio (M‐H, Fixed, 95% CI) 1.15 [0.59, 2.26]
12.1 800 mcg 2 941 Risk Ratio (M‐H, Fixed, 95% CI) 1.00 [0.35, 2.82]
12.2 600 mcg 0 0 Risk Ratio (M‐H, Fixed, 95% CI) 0.0 [0.0, 0.0]
12.3 400 mcg 4 1818 Risk Ratio (M‐H, Fixed, 95% CI) 1.28 [0.53, 3.12]
13 Headache 1   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
13.1 600 mcg 0 0 Risk Ratio (M‐H, Fixed, 95% CI) 0.0 [0.0, 0.0]
13.2 400 mcg 1 215 Risk Ratio (M‐H, Fixed, 95% CI) 2.36 [0.75, 7.42]
14 Abdominal pain 1   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
14.1 600 mcg 0 0 Risk Ratio (M‐H, Fixed, 95% CI) 0.0 [0.0, 0.0]
14.2 400 mcg 1 215 Risk Ratio (M‐H, Fixed, 95% CI) 0.97 [0.46, 2.02]
15 Diarrhoea 3 1978 Risk Ratio (M‐H, Fixed, 95% CI) 1.08 [0.56, 2.11]
15.1 800 mcg 1 514 Risk Ratio (M‐H, Fixed, 95% CI) 1.2 [0.37, 3.88]
15.2 600 mcg 0 0 Risk Ratio (M‐H, Fixed, 95% CI) 0.0 [0.0, 0.0]
15.3 400 mcg 2 1464 Risk Ratio (M‐H, Fixed, 95% CI) 1.03 [0.46, 2.31]
16 Any shivering 8   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
16.1 800 mcg 2 940 Risk Ratio (M‐H, Fixed, 95% CI) 38.6 [11.04, 134.95]
16.2 600 mcg 1 200 Risk Ratio (M‐H, Fixed, 95% CI) 1.23 [0.63, 2.42]
16.3 400 mcg 5 2143 Risk Ratio (M‐H, Fixed, 95% CI) 2.34 [1.88, 2.92]
17 Pyrexia (>= 38 degrees C) 3   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
17.1 600 mcg 1 200 Risk Ratio (M‐H, Fixed, 95% CI) 5.0 [0.24, 102.85]
17.2 400 mcg 2 1022 Risk Ratio (M‐H, Fixed, 95% CI) 2.08 [1.21, 3.57]