Summary of findings 5. One frequency of amniotic membranes sweeping compared to another frequency of amniotic membrane sweeping for induction of labour.
| One frequency of amniotic membrane sweeping compared to another frequency of amniotic membrane sweeping 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: 1 frequency of amniotic membrane sweeping Comparison: another frequency of amniotic membrane sweeping | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Risk with another frequency of amniotic membrane sweeping | Risk with one frequency of amniotic membrane sweeping | |||||
| Spontaneous onset of labour ‐ not reported | ‐ | ‐ | ‐ | ‐ | ‐ | This outcome was not reported. |
| Induction of labour | Study population | RR 1.19 (0.76 to 1.85) | 234 (1 RCT) | ⊕⊕⊝⊝ LOW 1 2 | ||
| 231 per 1000 | 275 per 1000 (175 to 427) | |||||
| Caesarean section | Study population | RR 0.93 (0.60 to 1.46) | 234 (1 RCT) | ⊕⊕⊝⊝ LOW 1 3 | ||
| 256 per 1000 | 238 per 1000 (154 to 374) | |||||
| Spontaneous vaginal birth | Study population | RR 1.00 (0.86 to 1.17) | 234 (1 RCT) | ⊕⊕⊕⊝ MODERATE 1 | ||
| 735 per 1000 | 735 per 1000 (632 to 860) | |||||
| Uterine hyperstimulation with/without fetal heart rate (FHR) changes ‐ not reported | ‐ | ‐ | ‐ | ‐ | ‐ | This outcome was not reported |
| Maternal death or serious maternal morbidity | Study population | RR 0.78 (0.30 to 2.02) | 234 (1 RCT) | ⊕⊕⊝⊝ LOW 1 4 | ||
| 77 per 1000 | 60 per 1000 (23 to 155) | |||||
| Neonatal death or serious neonatal perinatal morbidity | Study population | RR 2.00 (0.18 to 21.76) | 234 (1 RCT) | ⊕⊕⊝⊝ LOW 1 5 | ||
| 9 per 1000 | 17 per 1000 (2 to 186) | |||||
| *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 (allocation concealment) and we found high risk of performance bias.
2 We downgraded (1) level for risk of serious imprecision due to the total (cumulative) sample size of 350 being less than the optimal information size (OIS) of 1414
3 We downgraded (1) level for risk of serious imprecision due to the total (cumulative) sample size of 350 being less than the optimal information size (OIS) of 2252
4 We downgraded (1) level for risk of serious imprecision due to the total (cumulative) sample size of 350 being less than the optimal information size (OIS) of 6182
5 We downgraded (1) level for risk of serious imprecision due to the total (cumulative) sample size of 350 being less than the optimal information size (OIS) of 83538