Scolaris Content Display Scolaris Content Display

Section of partogram where labour progress is recorded
Figures and Tables -
Figure 1

Section of partogram where labour progress is recorded

Comparison 1 Partogram versus no partogram (studies carried out in high‐ and low‐resource settings), Outcome 1 Casearean section (overall).
Figures and Tables -
Analysis 1.1

Comparison 1 Partogram versus no partogram (studies carried out in high‐ and low‐resource settings), Outcome 1 Casearean section (overall).

Comparison 1 Partogram versus no partogram (studies carried out in high‐ and low‐resource settings), Outcome 2 Apgar score less than 7 at 5 minutes.
Figures and Tables -
Analysis 1.2

Comparison 1 Partogram versus no partogram (studies carried out in high‐ and low‐resource settings), Outcome 2 Apgar score less than 7 at 5 minutes.

Comparison 1 Partogram versus no partogram (studies carried out in high‐ and low‐resource settings), Outcome 3 Epidural analgesia.
Figures and Tables -
Analysis 1.3

Comparison 1 Partogram versus no partogram (studies carried out in high‐ and low‐resource settings), Outcome 3 Epidural analgesia.

Comparison 1 Partogram versus no partogram (studies carried out in high‐ and low‐resource settings), Outcome 4 Instrumental vaginal delivery.
Figures and Tables -
Analysis 1.4

Comparison 1 Partogram versus no partogram (studies carried out in high‐ and low‐resource settings), Outcome 4 Instrumental vaginal delivery.

Comparison 1 Partogram versus no partogram (studies carried out in high‐ and low‐resource settings), Outcome 5 Duration of first stage of labour.
Figures and Tables -
Analysis 1.5

Comparison 1 Partogram versus no partogram (studies carried out in high‐ and low‐resource settings), Outcome 5 Duration of first stage of labour.

Comparison 1 Partogram versus no partogram (studies carried out in high‐ and low‐resource settings), Outcome 6 Duration of second stage of labour.
Figures and Tables -
Analysis 1.6

Comparison 1 Partogram versus no partogram (studies carried out in high‐ and low‐resource settings), Outcome 6 Duration of second stage of labour.

Comparison 1 Partogram versus no partogram (studies carried out in high‐ and low‐resource settings), Outcome 7 Number of vaginal examinations.
Figures and Tables -
Analysis 1.7

Comparison 1 Partogram versus no partogram (studies carried out in high‐ and low‐resource settings), Outcome 7 Number of vaginal examinations.

Comparison 1 Partogram versus no partogram (studies carried out in high‐ and low‐resource settings), Outcome 8 Admission to special care nursery.
Figures and Tables -
Analysis 1.8

Comparison 1 Partogram versus no partogram (studies carried out in high‐ and low‐resource settings), Outcome 8 Admission to special care nursery.

Comparison 1 Partogram versus no partogram (studies carried out in high‐ and low‐resource settings), Outcome 9 Oxytocin augmentation.
Figures and Tables -
Analysis 1.9

Comparison 1 Partogram versus no partogram (studies carried out in high‐ and low‐resource settings), Outcome 9 Oxytocin augmentation.

Comparison 1 Partogram versus no partogram (studies carried out in high‐ and low‐resource settings), Outcome 10 Performance of artificial rupture of membranes during labour.
Figures and Tables -
Analysis 1.10

Comparison 1 Partogram versus no partogram (studies carried out in high‐ and low‐resource settings), Outcome 10 Performance of artificial rupture of membranes during labour.

Comparison 1 Partogram versus no partogram (studies carried out in high‐ and low‐resource settings), Outcome 11 Antibiotic use.
Figures and Tables -
Analysis 1.11

Comparison 1 Partogram versus no partogram (studies carried out in high‐ and low‐resource settings), Outcome 11 Antibiotic use.

Comparison 2 Partogram with 2‐hour action line versus partogram with 4‐hour action line (studies carried out in a high‐resource setting), Outcome 1 Caesarean section (overall).
Figures and Tables -
Analysis 2.1

Comparison 2 Partogram with 2‐hour action line versus partogram with 4‐hour action line (studies carried out in a high‐resource setting), Outcome 1 Caesarean section (overall).

Comparison 2 Partogram with 2‐hour action line versus partogram with 4‐hour action line (studies carried out in a high‐resource setting), Outcome 2 Caesarean section (distress).
Figures and Tables -
Analysis 2.2

Comparison 2 Partogram with 2‐hour action line versus partogram with 4‐hour action line (studies carried out in a high‐resource setting), Outcome 2 Caesarean section (distress).

Comparison 2 Partogram with 2‐hour action line versus partogram with 4‐hour action line (studies carried out in a high‐resource setting), Outcome 3 Caesarean section (delay).
Figures and Tables -
Analysis 2.3

Comparison 2 Partogram with 2‐hour action line versus partogram with 4‐hour action line (studies carried out in a high‐resource setting), Outcome 3 Caesarean section (delay).

Comparison 2 Partogram with 2‐hour action line versus partogram with 4‐hour action line (studies carried out in a high‐resource setting), Outcome 4 Instrumental vaginal delivery.
Figures and Tables -
Analysis 2.4

Comparison 2 Partogram with 2‐hour action line versus partogram with 4‐hour action line (studies carried out in a high‐resource setting), Outcome 4 Instrumental vaginal delivery.

Comparison 2 Partogram with 2‐hour action line versus partogram with 4‐hour action line (studies carried out in a high‐resource setting), Outcome 5 Serious maternal morbidity or death.
Figures and Tables -
Analysis 2.5

Comparison 2 Partogram with 2‐hour action line versus partogram with 4‐hour action line (studies carried out in a high‐resource setting), Outcome 5 Serious maternal morbidity or death.

Comparison 2 Partogram with 2‐hour action line versus partogram with 4‐hour action line (studies carried out in a high‐resource setting), Outcome 6 Negative childbirth experience.
Figures and Tables -
Analysis 2.6

Comparison 2 Partogram with 2‐hour action line versus partogram with 4‐hour action line (studies carried out in a high‐resource setting), Outcome 6 Negative childbirth experience.

Comparison 2 Partogram with 2‐hour action line versus partogram with 4‐hour action line (studies carried out in a high‐resource setting), Outcome 7 Cord pH less than 7.1.
Figures and Tables -
Analysis 2.7

Comparison 2 Partogram with 2‐hour action line versus partogram with 4‐hour action line (studies carried out in a high‐resource setting), Outcome 7 Cord pH less than 7.1.

Comparison 2 Partogram with 2‐hour action line versus partogram with 4‐hour action line (studies carried out in a high‐resource setting), Outcome 8 Apgar score less than 7 at 5 minutes.
Figures and Tables -
Analysis 2.8

Comparison 2 Partogram with 2‐hour action line versus partogram with 4‐hour action line (studies carried out in a high‐resource setting), Outcome 8 Apgar score less than 7 at 5 minutes.

Comparison 2 Partogram with 2‐hour action line versus partogram with 4‐hour action line (studies carried out in a high‐resource setting), Outcome 9 Admission to special care nursery.
Figures and Tables -
Analysis 2.9

Comparison 2 Partogram with 2‐hour action line versus partogram with 4‐hour action line (studies carried out in a high‐resource setting), Outcome 9 Admission to special care nursery.

Comparison 2 Partogram with 2‐hour action line versus partogram with 4‐hour action line (studies carried out in a high‐resource setting), Outcome 10 Oxytocin augmentation.
Figures and Tables -
Analysis 2.10

Comparison 2 Partogram with 2‐hour action line versus partogram with 4‐hour action line (studies carried out in a high‐resource setting), Outcome 10 Oxytocin augmentation.

Comparison 2 Partogram with 2‐hour action line versus partogram with 4‐hour action line (studies carried out in a high‐resource setting), Outcome 11 Performance of artificial rupture of the membranes during labour.
Figures and Tables -
Analysis 2.11

Comparison 2 Partogram with 2‐hour action line versus partogram with 4‐hour action line (studies carried out in a high‐resource setting), Outcome 11 Performance of artificial rupture of the membranes during labour.

Comparison 2 Partogram with 2‐hour action line versus partogram with 4‐hour action line (studies carried out in a high‐resource setting), Outcome 12 Serious neonatal morbidity or perinatal death.
Figures and Tables -
Analysis 2.12

Comparison 2 Partogram with 2‐hour action line versus partogram with 4‐hour action line (studies carried out in a high‐resource setting), Outcome 12 Serious neonatal morbidity or perinatal death.

Comparison 2 Partogram with 2‐hour action line versus partogram with 4‐hour action line (studies carried out in a high‐resource setting), Outcome 13 Blood loss > 500 ml.
Figures and Tables -
Analysis 2.13

Comparison 2 Partogram with 2‐hour action line versus partogram with 4‐hour action line (studies carried out in a high‐resource setting), Outcome 13 Blood loss > 500 ml.

Comparison 2 Partogram with 2‐hour action line versus partogram with 4‐hour action line (studies carried out in a high‐resource setting), Outcome 14 Epidural use.
Figures and Tables -
Analysis 2.14

Comparison 2 Partogram with 2‐hour action line versus partogram with 4‐hour action line (studies carried out in a high‐resource setting), Outcome 14 Epidural use.

Comparison 2 Partogram with 2‐hour action line versus partogram with 4‐hour action line (studies carried out in a high‐resource setting), Outcome 15 Vaginal examinations.
Figures and Tables -
Analysis 2.15

Comparison 2 Partogram with 2‐hour action line versus partogram with 4‐hour action line (studies carried out in a high‐resource setting), Outcome 15 Vaginal examinations.

Comparison 3 Partogram with 2‐hour action line versus partogram with 3‐hour action line (study carried out in a high‐resource setting), Outcome 1 Caesarean section (overall).
Figures and Tables -
Analysis 3.1

Comparison 3 Partogram with 2‐hour action line versus partogram with 3‐hour action line (study carried out in a high‐resource setting), Outcome 1 Caesarean section (overall).

Comparison 3 Partogram with 2‐hour action line versus partogram with 3‐hour action line (study carried out in a high‐resource setting), Outcome 2 Caesarean section (distress).
Figures and Tables -
Analysis 3.2

Comparison 3 Partogram with 2‐hour action line versus partogram with 3‐hour action line (study carried out in a high‐resource setting), Outcome 2 Caesarean section (distress).

Comparison 3 Partogram with 2‐hour action line versus partogram with 3‐hour action line (study carried out in a high‐resource setting), Outcome 3 Caesarean section (delay).
Figures and Tables -
Analysis 3.3

Comparison 3 Partogram with 2‐hour action line versus partogram with 3‐hour action line (study carried out in a high‐resource setting), Outcome 3 Caesarean section (delay).

Comparison 3 Partogram with 2‐hour action line versus partogram with 3‐hour action line (study carried out in a high‐resource setting), Outcome 4 Instrumental vaginal delivery.
Figures and Tables -
Analysis 3.4

Comparison 3 Partogram with 2‐hour action line versus partogram with 3‐hour action line (study carried out in a high‐resource setting), Outcome 4 Instrumental vaginal delivery.

Comparison 3 Partogram with 2‐hour action line versus partogram with 3‐hour action line (study carried out in a high‐resource setting), Outcome 5 Serious maternal morbidity or death.
Figures and Tables -
Analysis 3.5

Comparison 3 Partogram with 2‐hour action line versus partogram with 3‐hour action line (study carried out in a high‐resource setting), Outcome 5 Serious maternal morbidity or death.

Comparison 3 Partogram with 2‐hour action line versus partogram with 3‐hour action line (study carried out in a high‐resource setting), Outcome 6 Negative childbirth experience.
Figures and Tables -
Analysis 3.6

Comparison 3 Partogram with 2‐hour action line versus partogram with 3‐hour action line (study carried out in a high‐resource setting), Outcome 6 Negative childbirth experience.

Comparison 3 Partogram with 2‐hour action line versus partogram with 3‐hour action line (study carried out in a high‐resource setting), Outcome 7 Cord pH less than 7.1.
Figures and Tables -
Analysis 3.7

Comparison 3 Partogram with 2‐hour action line versus partogram with 3‐hour action line (study carried out in a high‐resource setting), Outcome 7 Cord pH less than 7.1.

Comparison 3 Partogram with 2‐hour action line versus partogram with 3‐hour action line (study carried out in a high‐resource setting), Outcome 8 Apgar score less than 7 at 5 minutes.
Figures and Tables -
Analysis 3.8

Comparison 3 Partogram with 2‐hour action line versus partogram with 3‐hour action line (study carried out in a high‐resource setting), Outcome 8 Apgar score less than 7 at 5 minutes.

Comparison 3 Partogram with 2‐hour action line versus partogram with 3‐hour action line (study carried out in a high‐resource setting), Outcome 9 Admission to special care nursery.
Figures and Tables -
Analysis 3.9

Comparison 3 Partogram with 2‐hour action line versus partogram with 3‐hour action line (study carried out in a high‐resource setting), Outcome 9 Admission to special care nursery.

Comparison 3 Partogram with 2‐hour action line versus partogram with 3‐hour action line (study carried out in a high‐resource setting), Outcome 10 Oxytocin augmentation.
Figures and Tables -
Analysis 3.10

Comparison 3 Partogram with 2‐hour action line versus partogram with 3‐hour action line (study carried out in a high‐resource setting), Outcome 10 Oxytocin augmentation.

Comparison 3 Partogram with 2‐hour action line versus partogram with 3‐hour action line (study carried out in a high‐resource setting), Outcome 11 Performance of artificial rupture of membranes during labour.
Figures and Tables -
Analysis 3.11

Comparison 3 Partogram with 2‐hour action line versus partogram with 3‐hour action line (study carried out in a high‐resource setting), Outcome 11 Performance of artificial rupture of membranes during labour.

Comparison 3 Partogram with 2‐hour action line versus partogram with 3‐hour action line (study carried out in a high‐resource setting), Outcome 12 Serious neonatal morbidity or perinatal death.
Figures and Tables -
Analysis 3.12

Comparison 3 Partogram with 2‐hour action line versus partogram with 3‐hour action line (study carried out in a high‐resource setting), Outcome 12 Serious neonatal morbidity or perinatal death.

Comparison 3 Partogram with 2‐hour action line versus partogram with 3‐hour action line (study carried out in a high‐resource setting), Outcome 13 Blood loss > 500 ml.
Figures and Tables -
Analysis 3.13

Comparison 3 Partogram with 2‐hour action line versus partogram with 3‐hour action line (study carried out in a high‐resource setting), Outcome 13 Blood loss > 500 ml.

Comparison 3 Partogram with 2‐hour action line versus partogram with 3‐hour action line (study carried out in a high‐resource setting), Outcome 14 Epidural use.
Figures and Tables -
Analysis 3.14

Comparison 3 Partogram with 2‐hour action line versus partogram with 3‐hour action line (study carried out in a high‐resource setting), Outcome 14 Epidural use.

Comparison 3 Partogram with 2‐hour action line versus partogram with 3‐hour action line (study carried out in a high‐resource setting), Outcome 15 Vaginal examinations.
Figures and Tables -
Analysis 3.15

Comparison 3 Partogram with 2‐hour action line versus partogram with 3‐hour action line (study carried out in a high‐resource setting), Outcome 15 Vaginal examinations.

Comparison 4 Partogram with 3‐hour action line versus partogram with 4‐hour action line (study carried out in a high‐resource setting), Outcome 1 Caesarean section (overall).
Figures and Tables -
Analysis 4.1

Comparison 4 Partogram with 3‐hour action line versus partogram with 4‐hour action line (study carried out in a high‐resource setting), Outcome 1 Caesarean section (overall).

Comparison 4 Partogram with 3‐hour action line versus partogram with 4‐hour action line (study carried out in a high‐resource setting), Outcome 2 Caesarean section (distress).
Figures and Tables -
Analysis 4.2

Comparison 4 Partogram with 3‐hour action line versus partogram with 4‐hour action line (study carried out in a high‐resource setting), Outcome 2 Caesarean section (distress).

Comparison 4 Partogram with 3‐hour action line versus partogram with 4‐hour action line (study carried out in a high‐resource setting), Outcome 3 Caesarean section (delay).
Figures and Tables -
Analysis 4.3

Comparison 4 Partogram with 3‐hour action line versus partogram with 4‐hour action line (study carried out in a high‐resource setting), Outcome 3 Caesarean section (delay).

Comparison 4 Partogram with 3‐hour action line versus partogram with 4‐hour action line (study carried out in a high‐resource setting), Outcome 4 Instrumental vaginal delivery.
Figures and Tables -
Analysis 4.4

Comparison 4 Partogram with 3‐hour action line versus partogram with 4‐hour action line (study carried out in a high‐resource setting), Outcome 4 Instrumental vaginal delivery.

Comparison 4 Partogram with 3‐hour action line versus partogram with 4‐hour action line (study carried out in a high‐resource setting), Outcome 5 Serious maternal morbidity or death.
Figures and Tables -
Analysis 4.5

Comparison 4 Partogram with 3‐hour action line versus partogram with 4‐hour action line (study carried out in a high‐resource setting), Outcome 5 Serious maternal morbidity or death.

Comparison 4 Partogram with 3‐hour action line versus partogram with 4‐hour action line (study carried out in a high‐resource setting), Outcome 6 Negative childbirth experience.
Figures and Tables -
Analysis 4.6

Comparison 4 Partogram with 3‐hour action line versus partogram with 4‐hour action line (study carried out in a high‐resource setting), Outcome 6 Negative childbirth experience.

Comparison 4 Partogram with 3‐hour action line versus partogram with 4‐hour action line (study carried out in a high‐resource setting), Outcome 7 Cord pH less than 7.1.
Figures and Tables -
Analysis 4.7

Comparison 4 Partogram with 3‐hour action line versus partogram with 4‐hour action line (study carried out in a high‐resource setting), Outcome 7 Cord pH less than 7.1.

Comparison 4 Partogram with 3‐hour action line versus partogram with 4‐hour action line (study carried out in a high‐resource setting), Outcome 8 Apgar score less than 7 at 5 minutes.
Figures and Tables -
Analysis 4.8

Comparison 4 Partogram with 3‐hour action line versus partogram with 4‐hour action line (study carried out in a high‐resource setting), Outcome 8 Apgar score less than 7 at 5 minutes.

Comparison 4 Partogram with 3‐hour action line versus partogram with 4‐hour action line (study carried out in a high‐resource setting), Outcome 9 Admission to special care nursery.
Figures and Tables -
Analysis 4.9

Comparison 4 Partogram with 3‐hour action line versus partogram with 4‐hour action line (study carried out in a high‐resource setting), Outcome 9 Admission to special care nursery.

Comparison 4 Partogram with 3‐hour action line versus partogram with 4‐hour action line (study carried out in a high‐resource setting), Outcome 10 Oxytocin augmentation.
Figures and Tables -
Analysis 4.10

Comparison 4 Partogram with 3‐hour action line versus partogram with 4‐hour action line (study carried out in a high‐resource setting), Outcome 10 Oxytocin augmentation.

Comparison 4 Partogram with 3‐hour action line versus partogram with 4‐hour action line (study carried out in a high‐resource setting), Outcome 11 Performance of artificial rupture of membranes during labour.
Figures and Tables -
Analysis 4.11

Comparison 4 Partogram with 3‐hour action line versus partogram with 4‐hour action line (study carried out in a high‐resource setting), Outcome 11 Performance of artificial rupture of membranes during labour.

Comparison 4 Partogram with 3‐hour action line versus partogram with 4‐hour action line (study carried out in a high‐resource setting), Outcome 12 Serious neonatal morbidity or perinatal death.
Figures and Tables -
Analysis 4.12

Comparison 4 Partogram with 3‐hour action line versus partogram with 4‐hour action line (study carried out in a high‐resource setting), Outcome 12 Serious neonatal morbidity or perinatal death.

Comparison 4 Partogram with 3‐hour action line versus partogram with 4‐hour action line (study carried out in a high‐resource setting), Outcome 13 Blood loss > 500 ml.
Figures and Tables -
Analysis 4.13

Comparison 4 Partogram with 3‐hour action line versus partogram with 4‐hour action line (study carried out in a high‐resource setting), Outcome 13 Blood loss > 500 ml.

Comparison 4 Partogram with 3‐hour action line versus partogram with 4‐hour action line (study carried out in a high‐resource setting), Outcome 14 Epidural use.
Figures and Tables -
Analysis 4.14

Comparison 4 Partogram with 3‐hour action line versus partogram with 4‐hour action line (study carried out in a high‐resource setting), Outcome 14 Epidural use.

Comparison 4 Partogram with 3‐hour action line versus partogram with 4‐hour action line (study carried out in a high‐resource setting), Outcome 15 Number of vaginal examinations in labour.
Figures and Tables -
Analysis 4.15

Comparison 4 Partogram with 3‐hour action line versus partogram with 4‐hour action line (study carried out in a high‐resource setting), Outcome 15 Number of vaginal examinations in labour.

Comparison 5 Partogram with alert line only versus partogram with alert and action line (study carried out in a low‐resource setting), Outcome 1 Caesarean section (overall).
Figures and Tables -
Analysis 5.1

Comparison 5 Partogram with alert line only versus partogram with alert and action line (study carried out in a low‐resource setting), Outcome 1 Caesarean section (overall).

Comparison 5 Partogram with alert line only versus partogram with alert and action line (study carried out in a low‐resource setting), Outcome 2 Instrumental vaginal delivery.
Figures and Tables -
Analysis 5.2

Comparison 5 Partogram with alert line only versus partogram with alert and action line (study carried out in a low‐resource setting), Outcome 2 Instrumental vaginal delivery.

Comparison 5 Partogram with alert line only versus partogram with alert and action line (study carried out in a low‐resource setting), Outcome 3 Oxytocin augmentation.
Figures and Tables -
Analysis 5.3

Comparison 5 Partogram with alert line only versus partogram with alert and action line (study carried out in a low‐resource setting), Outcome 3 Oxytocin augmentation.

Comparison 5 Partogram with alert line only versus partogram with alert and action line (study carried out in a low‐resource setting), Outcome 4 Low Apgar Score (less than 7 at 5 minutes).
Figures and Tables -
Analysis 5.4

Comparison 5 Partogram with alert line only versus partogram with alert and action line (study carried out in a low‐resource setting), Outcome 4 Low Apgar Score (less than 7 at 5 minutes).

Comparison 5 Partogram with alert line only versus partogram with alert and action line (study carried out in a low‐resource setting), Outcome 5 Perinatal death.
Figures and Tables -
Analysis 5.5

Comparison 5 Partogram with alert line only versus partogram with alert and action line (study carried out in a low‐resource setting), Outcome 5 Perinatal death.

Comparison 6 Earlier versus later intervention: combined analysis for trials in high‐ and low‐resource settings, Outcome 1 Caesarean section (overall) (New Outcome).
Figures and Tables -
Analysis 6.1

Comparison 6 Earlier versus later intervention: combined analysis for trials in high‐ and low‐resource settings, Outcome 1 Caesarean section (overall) (New Outcome).

Comparison 6 Earlier versus later intervention: combined analysis for trials in high‐ and low‐resource settings, Outcome 2 Apgar score low at 5 or 10 minutes.
Figures and Tables -
Analysis 6.2

Comparison 6 Earlier versus later intervention: combined analysis for trials in high‐ and low‐resource settings, Outcome 2 Apgar score low at 5 or 10 minutes.

Comparison 6 Earlier versus later intervention: combined analysis for trials in high‐ and low‐resource settings, Outcome 3 Instrumental delivery.
Figures and Tables -
Analysis 6.3

Comparison 6 Earlier versus later intervention: combined analysis for trials in high‐ and low‐resource settings, Outcome 3 Instrumental delivery.

Comparison 1. Partogram versus no partogram (studies carried out in high‐ and low‐resource settings)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Casearean section (overall) Show forest plot

2

1590

Risk Ratio (M‐H, Random, 95% CI)

0.64 [0.24, 1.70]

1.1 Low‐resource setting

1

434

Risk Ratio (M‐H, Random, 95% CI)

0.38 [0.24, 0.61]

1.2 High‐resource setting

1

1156

Risk Ratio (M‐H, Random, 95% CI)

1.03 [0.82, 1.28]

2 Apgar score less than 7 at 5 minutes Show forest plot

2

1596

Risk Ratio (M‐H, Random, 95% CI)

0.77 [0.29, 2.06]

2.1 Low‐resource setting

1

440

Risk Ratio (M‐H, Random, 95% CI)

0.46 [0.04, 5.00]

2.2 High‐resource setting

1

1156

Risk Ratio (M‐H, Random, 95% CI)

0.85 [0.29, 2.52]

3 Epidural analgesia Show forest plot

1

1156

Risk Ratio (M‐H, Fixed, 95% CI)

1.01 [0.98, 1.05]

3.1 High‐resource setting

1

1156

Risk Ratio (M‐H, Fixed, 95% CI)

1.01 [0.98, 1.05]

4 Instrumental vaginal delivery Show forest plot

2

1590

Risk Ratio (M‐H, Fixed, 95% CI)

1.00 [0.85, 1.17]

4.1 Low‐resource setting

1

434

Risk Ratio (M‐H, Fixed, 95% CI)

1.17 [0.79, 1.74]

4.2 High‐resource setting

1

1156

Risk Ratio (M‐H, Fixed, 95% CI)

0.97 [0.81, 1.15]

5 Duration of first stage of labour Show forest plot

1

1156

Mean Difference (IV, Fixed, 95% CI)

0.0 [‐0.21, 0.21]

5.1 High‐resource setting

1

1156

Mean Difference (IV, Fixed, 95% CI)

0.0 [‐0.21, 0.21]

6 Duration of second stage of labour Show forest plot

1

1156

Mean Difference (IV, Fixed, 95% CI)

0.0 [‐0.21, 0.21]

6.1 High‐resource setting

1

1156

Mean Difference (IV, Fixed, 95% CI)

0.0 [‐0.21, 0.21]

7 Number of vaginal examinations Show forest plot

1

1156

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

7.1 High‐resource setting

1

1156

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

8 Admission to special care nursery Show forest plot

1

1156

Risk Ratio (M‐H, Fixed, 95% CI)

0.94 [0.51, 1.75]

8.1 High‐resource setting

1

1156

Risk Ratio (M‐H, Fixed, 95% CI)

0.94 [0.51, 1.75]

9 Oxytocin augmentation Show forest plot

1

1156

Risk Ratio (M‐H, Fixed, 95% CI)

1.02 [0.95, 1.10]

9.1 High‐resource setting

1

1156

Risk Ratio (M‐H, Fixed, 95% CI)

1.02 [0.95, 1.10]

10 Performance of artificial rupture of membranes during labour Show forest plot

1

1156

Risk Ratio (M‐H, Fixed, 95% CI)

0.99 [0.88, 1.11]

10.1 High‐resource setting

1

1156

Risk Ratio (M‐H, Fixed, 95% CI)

0.99 [0.88, 1.11]

11 Antibiotic use Show forest plot

1

1156

Risk Ratio (M‐H, Fixed, 95% CI)

1.23 [0.88, 1.73]

11.1 High‐resource setting

1

1156

Risk Ratio (M‐H, Fixed, 95% CI)

1.23 [0.88, 1.73]

Figures and Tables -
Comparison 1. Partogram versus no partogram (studies carried out in high‐ and low‐resource settings)
Comparison 2. Partogram with 2‐hour action line versus partogram with 4‐hour action line (studies carried out in a high‐resource setting)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Caesarean section (overall) Show forest plot

2

3601

Risk Ratio (M‐H, Random, 95% CI)

1.06 [0.85, 1.32]

2 Caesarean section (distress) Show forest plot

2

3601

Risk Ratio (M‐H, Fixed, 95% CI)

1.30 [0.86, 1.96]

3 Caesarean section (delay) Show forest plot

2

3601

Risk Ratio (M‐H, Fixed, 95% CI)

0.98 [0.77, 1.25]

4 Instrumental vaginal delivery Show forest plot

2

3601

Risk Ratio (M‐H, Fixed, 95% CI)

0.91 [0.80, 1.03]

5 Serious maternal morbidity or death Show forest plot

2

3601

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

6 Negative childbirth experience Show forest plot

2

2269

Risk Ratio (M‐H, Random, 95% CI)

0.61 [0.28, 1.35]

7 Cord pH less than 7.1 Show forest plot

2

3601

Risk Ratio (M‐H, Fixed, 95% CI)

0.73 [0.44, 1.22]

8 Apgar score less than 7 at 5 minutes Show forest plot

2

3601

Risk Ratio (M‐H, Fixed, 95% CI)

0.82 [0.50, 1.35]

9 Admission to special care nursery Show forest plot

2

3601

Risk Ratio (M‐H, Fixed, 95% CI)

0.78 [0.46, 1.31]

10 Oxytocin augmentation Show forest plot

2

3601

Risk Ratio (M‐H, Fixed, 95% CI)

1.14 [1.05, 1.22]

11 Performance of artificial rupture of the membranes during labour Show forest plot

2

3601

Risk Ratio (M‐H, Fixed, 95% CI)

1.07 [0.99, 1.15]

12 Serious neonatal morbidity or perinatal death Show forest plot

2

3601

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

13 Blood loss > 500 ml Show forest plot

2

3601

Risk Ratio (M‐H, Fixed, 95% CI)

1.07 [0.90, 1.26]

14 Epidural use Show forest plot

2

3601

Risk Ratio (M‐H, Fixed, 95% CI)

1.04 [0.95, 1.14]

15 Vaginal examinations Show forest plot

2

3601

Mean Difference (IV, Fixed, 95% CI)

‐0.14 [‐0.27, ‐0.02]

Figures and Tables -
Comparison 2. Partogram with 2‐hour action line versus partogram with 4‐hour action line (studies carried out in a high‐resource setting)
Comparison 3. Partogram with 2‐hour action line versus partogram with 3‐hour action line (study carried out in a high‐resource setting)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Caesarean section (overall) Show forest plot

1

617

Risk Ratio (M‐H, Fixed, 95% CI)

0.78 [0.51, 1.18]

2 Caesarean section (distress) Show forest plot

1

617

Risk Ratio (M‐H, Fixed, 95% CI)

0.96 [0.44, 2.10]

3 Caesarean section (delay) Show forest plot

1

617

Risk Ratio (M‐H, Fixed, 95% CI)

0.71 [0.42, 1.19]

4 Instrumental vaginal delivery Show forest plot

1

617

Risk Ratio (M‐H, Fixed, 95% CI)

0.93 [0.69, 1.26]

5 Serious maternal morbidity or death Show forest plot

1

617

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

6 Negative childbirth experience Show forest plot

1

348

Risk Ratio (M‐H, Fixed, 95% CI)

0.49 [0.27, 0.90]

7 Cord pH less than 7.1 Show forest plot

1

617

Risk Ratio (M‐H, Fixed, 95% CI)

0.38 [0.07, 1.96]

8 Apgar score less than 7 at 5 minutes Show forest plot

1

617

Risk Ratio (M‐H, Fixed, 95% CI)

1.44 [0.41, 5.05]

9 Admission to special care nursery Show forest plot

1

617

Risk Ratio (M‐H, Fixed, 95% CI)

3.83 [0.43, 34.12]

10 Oxytocin augmentation Show forest plot

1

617

Risk Ratio (M‐H, Fixed, 95% CI)

1.02 [0.85, 1.21]

11 Performance of artificial rupture of membranes during labour Show forest plot

1

617

Risk Ratio (M‐H, Fixed, 95% CI)

0.94 [0.77, 1.15]

12 Serious neonatal morbidity or perinatal death Show forest plot

1

617

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

13 Blood loss > 500 ml Show forest plot

1

617

Risk Ratio (M‐H, Fixed, 95% CI)

0.96 [0.63, 1.45]

14 Epidural use Show forest plot

1

617

Risk Ratio (M‐H, Fixed, 95% CI)

1.16 [0.94, 1.44]

15 Vaginal examinations Show forest plot

1

617

Mean Difference (IV, Fixed, 95% CI)

0.0 [‐0.29, 0.29]

Figures and Tables -
Comparison 3. Partogram with 2‐hour action line versus partogram with 3‐hour action line (study carried out in a high‐resource setting)
Comparison 4. Partogram with 3‐hour action line versus partogram with 4‐hour action line (study carried out in a high‐resource setting)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Caesarean section (overall) Show forest plot

1

613

Risk Ratio (M‐H, Fixed, 95% CI)

1.70 [1.07, 2.70]

2 Caesarean section (distress) Show forest plot

1

613

Risk Ratio (M‐H, Fixed, 95% CI)

1.77 [0.70, 4.42]

3 Caesarean section (delay) Show forest plot

1

613

Risk Ratio (M‐H, Fixed, 95% CI)

1.68 [0.97, 2.91]

4 Instrumental vaginal delivery Show forest plot

1

613

Risk Ratio (M‐H, Fixed, 95% CI)

0.96 [0.72, 1.28]

5 Serious maternal morbidity or death Show forest plot

1

613

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

6 Negative childbirth experience Show forest plot

1

340

Risk Ratio (M‐H, Fixed, 95% CI)

0.80 [0.51, 1.27]

7 Cord pH less than 7.1 Show forest plot

1

613

Risk Ratio (M‐H, Fixed, 95% CI)

2.57 [0.50, 13.17]

8 Apgar score less than 7 at 5 minutes Show forest plot

1

613

Risk Ratio (M‐H, Fixed, 95% CI)

0.82 [0.22, 3.04]

9 Admission to special care nursery Show forest plot

1

613

Risk Ratio (M‐H, Fixed, 95% CI)

0.51 [0.05, 5.65]

10 Oxytocin augmentation Show forest plot

1

613

Risk Ratio (M‐H, Fixed, 95% CI)

1.09 [0.91, 1.30]

11 Performance of artificial rupture of membranes during labour Show forest plot

1

613

Risk Ratio (M‐H, Fixed, 95% CI)

1.04 [0.85, 1.26]

12 Serious neonatal morbidity or perinatal death Show forest plot

1

613

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

13 Blood loss > 500 ml Show forest plot

1

613

Risk Ratio (M‐H, Fixed, 95% CI)

1.03 [0.68, 1.56]

14 Epidural use Show forest plot

1

613

Risk Ratio (M‐H, Fixed, 95% CI)

1.01 [0.80, 1.27]

15 Number of vaginal examinations in labour Show forest plot

1

613

Mean Difference (IV, Fixed, 95% CI)

0.10 [‐0.19, 0.39]

Figures and Tables -
Comparison 4. Partogram with 3‐hour action line versus partogram with 4‐hour action line (study carried out in a high‐resource setting)
Comparison 5. Partogram with alert line only versus partogram with alert and action line (study carried out in a low‐resource setting)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Caesarean section (overall) Show forest plot

1

694

Risk Ratio (M‐H, Fixed, 95% CI)

0.68 [0.50, 0.93]

2 Instrumental vaginal delivery Show forest plot

1

694

Risk Ratio (M‐H, Fixed, 95% CI)

0.87 [0.66, 1.15]

3 Oxytocin augmentation Show forest plot

1

694

Risk Ratio (M‐H, Fixed, 95% CI)

0.81 [0.62, 1.05]

4 Low Apgar Score (less than 7 at 5 minutes) Show forest plot

1

2

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

5 Perinatal death Show forest plot

1

694

Risk Ratio (M‐H, Fixed, 95% CI)

7.12 [0.37, 137.36]

Figures and Tables -
Comparison 5. Partogram with alert line only versus partogram with alert and action line (study carried out in a low‐resource setting)
Comparison 6. Earlier versus later intervention: combined analysis for trials in high‐ and low‐resource settings

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Caesarean section (overall) (New Outcome) Show forest plot

3

4295

Risk Ratio (M‐H, Random, 95% CI)

0.94 [0.67, 1.31]

1.1 Low‐resource setting

1

694

Risk Ratio (M‐H, Random, 95% CI)

0.68 [0.50, 0.93]

1.2 High‐resource setting

2

3601

Risk Ratio (M‐H, Random, 95% CI)

1.06 [0.85, 1.32]

2 Apgar score low at 5 or 10 minutes Show forest plot

3

4295

Risk Ratio (M‐H, Random, 95% CI)

0.95 [0.48, 1.86]

2.1 Low‐resource setting

1

694

Risk Ratio (M‐H, Random, 95% CI)

7.12 [0.37, 137.36]

2.2 High‐resource setting

2

3601

Risk Ratio (M‐H, Random, 95% CI)

0.82 [0.50, 1.35]

3 Instrumental delivery Show forest plot

3

4295

Risk Ratio (M‐H, Random, 95% CI)

0.90 [0.80, 1.02]

3.1 Low‐resource setting

1

694

Risk Ratio (M‐H, Random, 95% CI)

0.87 [0.66, 1.15]

3.2 High‐resource setting

2

3601

Risk Ratio (M‐H, Random, 95% CI)

0.91 [0.80, 1.03]

Figures and Tables -
Comparison 6. Earlier versus later intervention: combined analysis for trials in high‐ and low‐resource settings