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Temas

Section of partogram where labour progress is recorded
Figuras y tablas -
Figure 1

Section of partogram where labour progress is recorded

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

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

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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.
Figuras y tablas -
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.

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

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

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

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

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

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

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

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

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

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

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

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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.
Figuras y tablas -
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.

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

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

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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).
Figuras y tablas -
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).

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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).
Figuras y tablas -
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).

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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).
Figuras y tablas -
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).

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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.
Figuras y tablas -
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.

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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.
Figuras y tablas -
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.

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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.
Figuras y tablas -
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.

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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.
Figuras y tablas -
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.

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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.
Figuras y tablas -
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.

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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.
Figuras y tablas -
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.

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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.
Figuras y tablas -
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.

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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.
Figuras y tablas -
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.

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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.
Figuras y tablas -
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.

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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.
Figuras y tablas -
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.

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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.
Figuras y tablas -
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.

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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.
Figuras y tablas -
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.

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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).
Figuras y tablas -
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).

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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).
Figuras y tablas -
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).

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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).
Figuras y tablas -
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).

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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.
Figuras y tablas -
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.

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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.
Figuras y tablas -
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.

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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.
Figuras y tablas -
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.

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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.
Figuras y tablas -
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.

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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.
Figuras y tablas -
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.

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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.
Figuras y tablas -
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.

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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.
Figuras y tablas -
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.

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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.
Figuras y tablas -
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.

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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.
Figuras y tablas -
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.

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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.
Figuras y tablas -
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.

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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.
Figuras y tablas -
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.

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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.
Figuras y tablas -
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.

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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).
Figuras y tablas -
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).

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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).
Figuras y tablas -
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).

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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).
Figuras y tablas -
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).

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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.
Figuras y tablas -
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.

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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.
Figuras y tablas -
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.

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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.
Figuras y tablas -
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.

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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.
Figuras y tablas -
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.

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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.
Figuras y tablas -
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.

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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.
Figuras y tablas -
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.

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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.
Figuras y tablas -
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.

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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.
Figuras y tablas -
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.

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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.
Figuras y tablas -
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.

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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.
Figuras y tablas -
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.

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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.
Figuras y tablas -
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.

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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.
Figuras y tablas -
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.

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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).
Figuras y tablas -
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).

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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.
Figuras y tablas -
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.

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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.
Figuras y tablas -
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.

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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).
Figuras y tablas -
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).

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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.
Figuras y tablas -
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.

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

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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.
Figuras y tablas -
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.

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

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

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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]
Figuras y tablas -
Comparison 1. Partogram versus no partogram (studies carried out in high‐ and low‐resource settings)
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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]
Figuras y tablas -
Comparison 2. Partogram with 2‐hour action line versus partogram with 4‐hour action line (studies carried out in a high‐resource setting)
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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]
Figuras y tablas -
Comparison 3. Partogram with 2‐hour action line versus partogram with 3‐hour action line (study carried out in a high‐resource setting)
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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]
Figuras y tablas -
Comparison 4. Partogram with 3‐hour action line versus partogram with 4‐hour action line (study carried out in a high‐resource setting)
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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]
Figuras y tablas -
Comparison 5. Partogram with alert line only versus partogram with alert and action line (study carried out in a low‐resource setting)
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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]
Figuras y tablas -
Comparison 6. Earlier versus later intervention: combined analysis for trials in high‐ and low‐resource settings
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