Inducing labor after fetal demise: a systematic review and meta-analysis of the efficacy and safety of mifepristone and misoprostol combination versus misoprostol alone

Table 3 GRADE evidence profiles for primary outcomes among the trials included in the systematic review

Certainty assessment							№ of patients		Effect		Certainty	Importance
№ of studies	Study design	Risk of bias	Inconsistency	Indirectness	Imprecision	Other considerations	[mifepristone and misoprostol]	[misoprostol]	Relative (95% CI)	Absolute (95% CI)	Certainty	Importance
Induction delivery interval
10	randomised trials	serious^a	not serious^b	not serious	not serious	publication bias strongly suspected^c	356	354	-	MD 7.86 lower (9.98 lower to 5.73 lower)	⨁⨁◯◯ Low^a,b,c	CRITICAL
Number of misoprostol doses
9	randomised trials	serious^a	not serious^b	not serious	not serious	none	315	316	-	MD 1.38 lower (1.82 lower to 0.94 lower)	⨁⨁⨁◯ Moderate^a,b	CRITICAL
Total dose of misoprostol
4	randomised trials	serious^a	not serious^b	not serious	serious^d	none	165	172	-	MD 60.51 lower (106.98 lower to 14.04 lower)	⨁⨁◯◯ Low^a,b,d	CRITICAL

CIConfidence interval; MD Mean difference
Explanations
^aThe overall bias is high in most studies
^bAlthough heterogeneity is high, the heterogeneity is caused by differences in the magnitude of effectiveness rather than by effectiveness and ineffectiveness
^cThe funnel plot is not symmetrical
^dThe total sample size is less than 400

ISSN: 1471-2393