Misoprostol administration prior to intrauterine contraceptive device insertion: a systematic review and meta-analysis of randomised controlled trials

Tassi, Alice; Parisi, Nadia; Londero, Ambrogio P.

doi:10.1080/13625187.2019.1706079

Cited by 9 publications

(8 citation statements)

References 50 publications

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“…Also, in a systematic meta-analysis in 2020, Tassi et al concluded that sublingual misoprostol did not show improvement in the facilitation of insertion. However, the use of misoprostol is usually associated with patient comfort 22 . Some other studies did not demonstrate enhancement in the facilitation of insertion 23,24 .…”

Section: Discussionmentioning

confidence: 99%

Role of vaginal misoprostol prior to levonorgestrel-releasing IUD insertion

Salama

Eltemamy

Abdel-Rasheed

et al. 2022

Al-Azhar International Medical Journal

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Section: Discussionmentioning

confidence: 99%

Role of vaginal misoprostol prior to levonorgestrel-releasing IUD insertion

Salama

Eltemamy

Abdel-Rasheed

et al. 2022

Al-Azhar International Medical Journal

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“…In addition, the Egger's regression test of funnel plot asymmetry and the rank correlation test by Begg and Mazumdar were used to assess publication bias [13][14][15]. As previously described, heterogeneity between studies was evaluated by I-square index (heterogeneous with a value above 50 %), and the Cochran Q (heterogeneous with a p-value below 0.100) and fixed-or the random-effects model were used as appropriate [16,17]. The primary outcome was presented as a pooled propor-tion with a 95 % confidence interval (CI), where arcsine transformation was used in case of low-prevalence events, and the secondary outcomes were presented as pooled proportion or pooled odds ratio (OR) with 95 % CI.…”

Section: Discussionmentioning

confidence: 99%

Trial of Labor after Three or More Previous Cesarean Sections: Systematic Review and Meta-Analysis of Observational Studies

Fruscalzo

Rossetti

Londero

2022

Z Geburtshilfe Neonatol

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Aims To assess the success rate and prevalence of maternal or neonatal complications in women undergoing a trial of labor after three or more (≥3) previous cesarean sections (CSs). Methods A systematic literature review and meta-analysis was conducted from inception to May 2022 in Medline, Scopus, ENBASE, ClinicalTrials.gov, and the Cochrane Central Register of Controlled Trials and Reviews. Items detailing success rate and complications in women with a history of≥3 previous CSs were considered. Selected articles were evaluated for quality, heterogeneity, and publication bias. A pooled prevalence or odds ratio was calculated. Findings Twelve articles were included for a total of 540 women with a history of≥3 CSs, accounting for the 2% (CI 95% 1–4%) of the whole cohort of trial of labor. Our findings show a 0.67 (CI 95% 0.53–0.78) rate of successful vaginal delivery. A higher success rate was observed in women having a history of a prior vaginal delivery (0.90, CI 95% 0.77–0.96) and when prostaglandins, peridural anesthesia or oxytocin were allowed (respectively 0.73, CI 95% 0.62–0.83, 0,73, CI 95% 0.57–0.85 and 0.73, CI 95% 0.64–0.81). Uterine rupture rate was 0.01 (CI 95% 0.00–0.01). No cases of fetal asphyxia or maternal or neonatal death were registered. Conclusions The success rate and low frequency of severe complications observed seem to support a trial of labor in selected patients desiring a natural birth. However, a potential underestimation of serious maternal and neonatal complications should be considered in the decision-making process.

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“…Moreover, the authors systematically reviewed all included studies for characteristics that could introduce possible bias (e.g., procedures for participant identification, differences in the duration of follow-ups between cases and controls, the comparability of risk factors for recurrence present at diagnosis for cases and controls). Continuous data were collected as mean and standard deviation according to the previously described methods [ 10 , 11 ]. As previously described, any discrepancies in data extraction or the suitability or otherwise of a study were jointly discussed until a consensus was reached [ 12 ].…”

Section: Methodsmentioning

confidence: 99%

Hormone Replacement Therapy in Endometrial Cancer Survivors: A Meta-Analysis

Londero

Parisi

Tassi

et al. 2021

JCM

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The purpose of this study is to investigate the effect of hormone therapy (HT) on the oncological outcomes of endometrial cancer (EC) survivors. A systematic literature review was conducted in July 2021 to identify studies detailing the effect size for the relationship between HT use in EC and oncological outcomes (survival and disease recurrence). This included studies that evaluated the different recurrence rates among women treated for EC who subsequently underwent HT and those who did not. The collected studies were evaluated for quality, heterogeneity, and publication bias, and a pooled odds ratio (OR) or hazard ratio (HR) was calculated with a confidence interval of 95% (95% CI). In total, 5291 studies were collated, and after the review process, one randomized trial and seven observational studies were included, comprising 1801 EC survivors treated with HT and 6015 controls. The time-dependent analysis could be conducted for four studies, and considering the disease-free survival, the pooled HR of 0.90 (95% CI 0.28 to 2.87) showed no significant differences. However, among Black American women treated with continuous estrogen HT, the HR was 7.58 (95% CI 1.96 to 29.31), showing a significantly increased risk of recurrence for women in this ethnic group. Considering the pooled OR of all included studies 0.63 (95% CI 0.48 to 0.83), a significantly reduced risk of recurrence was found among EC survivors treated with HT. Considering the type of HT, the most risk-reducing was combined estrogen and progestin therapy and the cyclic regimen. Although supporting evidence is based mainly upon observational studies, evidence of no increased risk or even decreased risk was generally found, apart from in Black American women where a significantly increased recurrence risk was evident. The data are rather reassuring for the short-term administration of HT to symptomatic EC survivors. Future studies with a longer follow-up are necessary to better clarify the long-term effects of HT.

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Misoprostol administration prior to intrauterine contraceptive device insertion: a systematic review and meta-analysis of randomised controlled trials

Abstract: INCLUDED STUDIESStudies that fulfilled the requirements.

Cited by 9 publications

References 50 publications

Role of vaginal misoprostol prior to levonorgestrel-releasing IUD insertion

Role of vaginal misoprostol prior to levonorgestrel-releasing IUD insertion

Trial of Labor after Three or More Previous Cesarean Sections: Systematic Review and Meta-Analysis of Observational Studies

Hormone Replacement Therapy in Endometrial Cancer Survivors: A Meta-Analysis

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