Summary of findings 3. Amniotic membranes sweeping compared to intravenous oxytocin/amniotomy for induction of labour.
| Amniotic membrane sweeping compared to intravenous oxytocin +/‐ amniotomy for induction of labour | ||||||
| Patient or population: pregnant women carrying a live fetus at or near term (≥ 36 weeks' gestation). Setting: antenatal environments where amniotic membrane sweeping is likely to be used. Intervention: amniotic membrane sweeping Comparison: intravenous oxytocin +/‐ amniotomy | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Risk with intravenous oxytocin +/‐ amniotomy | Risk with amniotic membrane sweeping | |||||
| Spontaneous onset of labour | Study population | RR 1.32 (0.88 to 1.96) | 69 (1 RCT) | ⊕⊕⊝⊝ LOW 1 2 | ||
| 514 per 1000 | 679 per 1000 (453 to 1000) | |||||
| Induction of labour | Study population | RR 0.51 (0.05 to 5.42) | 69 (1 RCT) | ⊕⊕⊝⊝ LOW 1 3 | ||
| 57 per 1000 | 29 per 1000 (3 to 310) | |||||
| Caesarean section | Study population | RR 0.69 (0.12 to 3.85) | 69 (1 RCT) | ⊕⊕⊝⊝ LOW 1 4 | ||
| 86 per 1000 | 59 per 1000 (10 to 330) | |||||
| Spontaneous vaginal birth ‐ not reported | ‐ | ‐ | ‐ | ‐ | ‐ | This outcome was not reported on. |
| Uterine hyperstimulation with/without fetal heart (FHR) rate changes ‐ not reported | ‐ | ‐ | ‐ | ‐ | ‐ | This outcome was not reported on. |
| Maternal death or serious maternal morbidity | Study population | not estimable | 69 (1 RCT) | ⊕⊕⊝⊝ LOW 1 5 | ||
| 0 per 1000 | 0 per 1000 (0 to 0) | |||||
| Neonatal death or serious neonatal perinatal morbidity | ‐ | ‐ | ‐ | ‐ | ‐ | This outcome was not reported on. |
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk ratio | ||||||
| GRADE Working Group grades of evidence High certainty: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: we are moderately confident in the effect estimate; the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: our confidence in the effect estimate is limited; the true effect may be substantially different from the estimate of the effect. Very low certainty: we have very little confidence in the effect estimate; the true effect is likely to be substantially different from the estimate of effect. | ||||||
1 We downgraded (1) level for risk of serious bias due to evidence of design limitations in this trial. We found unclear risk of selection bias (random sequence generation and allocation concealment). We found high risk of performance bias. We found unclear risk of both detection bias and reporting bias.
2 We downgraded (1) level for risk of serious imprecision due to the total (cumulative) sample size of 69 being less than the optimal information size (OIS) of 718
3 We downgraded (1) level for risk of serious imprecision due to the total (cumulative) sample size of 69 being less than the optimal information size (OIS) of 11212
4 We downgraded (1) level for risk of serious imprecision due to the total (cumulative) sample size of 69 being less than the optimal information size (OIS) of 7642
5 We downgraded (1) level for risk of serious imprecision due to small sample size with no events recorded.