WHO recommendations on induction of labour, at or beyond term: web annex: evidence-to-decision framework
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World Health Organization
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27 p.
This web annex accompanies the WHO recommendations on induction of labour, at or beyond term and documents the evidence-to-decision (EtD) framework used to inform the guideline recommendation on induction of labour compared with expectant management in pregnant women at or beyond term. It summarizes the evidence reviewed by the WHO Guideline Development Group across key EtD domains, including the balance of desirable and undesirable effects, certainty of the evidence, women’s values and preferences, resource implications, equity, acceptability and feasibility. The document also presents the clinical question, priority maternal and neonatal outcomes, GRADE judgements and summary of findings tables. Drawing primarily on systematic reviews and GRADE assessments, the annex examines the effects of labour induction on maternal and perinatal outcomes, together with qualitative evidence on women’s experiences and contextual considerations relevant to implementation. It reviews available economic evidence, discusses implications for health systems and workforce capacity, and considers equity and human rights issues related to informed decision-making and access to appropriate care. By transparently documenting the evidence and judgements underpinning the recommendation, the annex supports consistent interpretation of the guideline development process and facilitates adaptation and implementation in different health-care settings.
This web annex accompanies the WHO recommendations on induction of labour, at or beyond term and documents the evidence-to-decision (EtD) framework used to inform the guideline recommendation on induction of labour compared with expectant management in pregnant women at or beyond term. It summarizes the evidence reviewed by the WHO Guideline Development Group across key EtD domains, including the balance of desirable and undesirable effects, certainty of the evidence, women’s values and preferences, resource implications, equity, acceptability and feasibility. The document also presents the clinical question, priority maternal and neonatal outcomes, GRADE judgements and summary of findings tables. Drawing primarily on systematic reviews and GRADE assessments, the annex examines the effects of labour induction on maternal and perinatal outcomes, together with qualitative evidence on women’s experiences and contextual considerations relevant to implementation. It reviews available economic evidence, discusses implications for health systems and workforce capacity, and considers equity and human rights issues related to informed decision-making and access to appropriate care. By transparently documenting the evidence and judgements underpinning the recommendation, the annex supports consistent interpretation of the guideline development process and facilitates adaptation and implementation in different health-care settings.