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Table 3 Summary: Quality of Evidence and Grades of Recommendation[11, 12]

From: Methods of induction of labour: a systematic review

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