Table 3 Summary: Quality of Evidence and Grades of Recommendation[11, 12]
Method | Quality of evidence | Balance of Benefits/Harms | Grade of Recommendation |
|---|---|---|---|
Vaginal PGE2 | Moderate | Trade-offs | Strong |
Cervical PGE2 | Moderate | Net benefits | Strong |
Intravenous oxytocin | Moderate | Trade-offs | Strong |
Amniotomy | Moderate | Uncertain trade-offs | Weak |
Intravenous oxytocin plus Amniotomy | Moderate | Trade-offs | Strong |
Vaginal misoprostol | Moderate | Trade-offs | Strong |
Oral misoprostol | Moderate | Trade-offs | Strong |
Mechanical methods | Moderate | Trade-offs | Weak |
Membrane sweeping | Moderate | Net benefits | Strong |
Extra-amniotic prostaglandins | Moderate | No net benefit | Strong (against) |
Intravenous prostaglandins | Moderate | Net harms | Strong (against) |
Oral prostaglandins | Moderate | Net harms | Strong (against) |
Mifepristone | Moderate | Net harms | Weak |
Oestrogens | Very Low | Uncertain trade-offs | Weak |
Corticosteroids | Very Low | Uncertain trade-offs | Weak |
Relaxin | Moderate | Uncertain trade-offs | Weak |
Hyaluronidase | Very low | Uncertain trade-offs | Weak |
Castor oil | Very Low | Net harms | Strong (against) |
Acupuncture | Moderate | No net benefit | Weak |
Breast stimulation | Moderate | Uncertain trade-offs | Weak |
Sexual intercourse | Very low | Uncertain trade-offs | Weak |
Homeopathic Methods | Very low | Uncertain trade-offs | Weak |
Isosorbide mononitrate | Moderate | Uncertain trade-offs | Weak |
Buccal or sublingual misoprostol | Moderate | Trade-offs | Strong |
Hypnosis | Very low | No net benefit | Weak |