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Table 5 Effect estimates and certainty of evidence for clinical interventions that influence uterine dehiscence rates

From: Clinical interventions that influence vaginal birth after cesarean delivery rates: Systematic Review & Meta-Analysis

Comparison

No. of studies

Comparison 1 (no. of women with uterine dehiscence/no. of women)

Comparison 2 (no. of women with uterine dehiscence/no. of women)

Risk Difference, M-H, Random (95% CI)

I2 (%)

Quality

Pharmacologic induction

 PGE1 vs. spontaneous labor

Prospective cohort (2)

5/117

6/357

0.02 (−0.06, 0.09)

65

Very Low

 PGE2 vs. spontaneous labor

Prospective cohort (2)

1/171

0/222

0.01 (−0.01, 0.02)

0

Very Low

 Oxytocin vs. spontaneous labor

Prospective cohort (3)

Retrospective cohort (2)

21/1113

16/2298

0.01 (0.00, 0.02)

20

Very Low

 Mifepristone vs. placebo

RCT (1)

1/16

1/16

0.00 (− 0.17, 0.17)

NA

Low

 Epidural analgesia vs. no epidural

Retrospective cohort (1)

4/87

1/150

0.04 (− 0.01, 0.09)

NA

Very Low

 Oxytocin vs. PGE2

Prospective cohort (1)

1/208

1/146

0.00 (−0.02, 0.01)

NA

Very Low

 Active inpatient management (+/− oxytocin) vs. expectant outpatient management (+/− oxytocin)

RCT (1)

5/95

0/93

0.05 (0.00, 0.10)

NA

Very Low

Non-pharmacologic induction

 Membrane sweep vs. spontaneous labor

RCT (1)

0/62

1/61

-0.02 (− 0.06, 0.03)

NA

Very Low

 30 mL Foley catheter vs. 80 mL Foley catheter

RCT (1)

2/77

7/77

−0.06 (− 0.14, 0.01)

NA

Low

Pharmacologic vs. Non-pharmacologic or Combined (pharmacologic + non-pharmacologic)

 Oxytocin +/− amniotomy vs. amniotomy

Retrospective cohort (1)

4/102

0/35

0.04 (− 0.02, 0.09)

NA

Very Low

 Induction (PGE2, oxytocin, amniotomy and/or Foley catheter) vs. spontaneous labor

Retrospective cohort (1)

13/1576

36/4263

0.00 (− 0.01, 0.01)

NA

Very Low

 Induction (oxytocin, PGE2, misoprostol + oxytocin [augmentation]) vs. spontaneous labor

Retrospective cohort (1)

4/57

3/179

0.05 (−0.02, 0.12)

NA

Very Low

  1. CI confidence interval, NA not applicable, NS not specified, no. number, PGE1/PGE2 prostaglandin 1/prostaglandin 2; RCT randomized clinical trial, VD vaginal delivery, vs. versus