Table 5 Blood transfusion
Intervention and comparison intervention | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | Number of participants (studies) | Quality of the evidence (GRADE) | Comments | |
|---|---|---|---|---|---|---|
Risk with comparison | Risk with intervention | |||||
Active management | ||||||
 McCormick 2002 [48] Active versus physiological management of third stage of labour | 30 per 1000 | 9 per 1000 (6 to 15) | RR 0.32 (0.20–0.51) | 4855 (3 studies) | Low | Serious risk of bias, serious imprecision |
 Begley 2015 [21] Active versus expectant management of third stage of labour | 29 per 1000 | 10 per 1000 (6 to 16) | RR 0.35 (0.22–0.55) | 4829 (4 studies) | Moderate | Serious imprecision |
 Du 2014 [47] Active management with CCT versus without CCT | 5 per 1000 | 5 per 1000 (3 to 7) | RR 0.96 (0.69–1.33) | 28,062 (3 studies) | Moderate | Serious risk of bias |
 Hofmeyr 2015 [23] Active management with CCT versus without CCT | 5 per 1000 | 5 per 1000 (3 to 7) | RR 0.94 (0.68–1.32) | 27,662 (2 studies) | High |  |
Oxytocin | ||||||
 Westhoff 2013 [29] Oxytocin versus placebo | 12 per 1000 | 10 per 1000 (5 to 21) | RR 0.89 (0.44–1.78) | 3120 (3 studies) | Moderate | Serious imprecision |
 Soltani 2010 [27] Use of oxytocics before versus after delivery of placenta | 7 per 1000 | 6 per 1000 (2 to 20) | RR 0.79 (0.23–2.73) | 1667 (3 studies) | Moderate | Serious imprecision |
 Mori 2012 [25] Umbilical vein injection of a saline versus oxytocin with a saline alone | Not estimable | Not estimable | RR 3.32 (0.14–78.97) | 78 (1 study) | Low | Serious inconsistency, serious imprecision |
Prostaglandin | ||||||
 Tunçalp 2012 [32] Oral misoprostol (400–600 mcg) versus placebo or no uterotonics | 7 per 1000 | 2 per 1000 (1 to 6) | RR 0.31 (0.10–0.94) | 3519 (5 studies) | Moderate | Serious imprecision |
 Tunçalp 2012 [32] Buccal misoprostol (200 mcg) versus placebo or no uterotonics | 16 per 1000 | 11 per 1000 (4 to 30) | RR 0.68 (0.24–1.89) | 1108 (2 studies) | Moderate | Serious imprecision |
 Olefile 2013 [55] Oral misoprostol (600 mcg) versus placebo | 9 per 1000 | 1 per 1000 (0 to 10) | RR 0.14 (0.02–1.15) | 1620 (1 study) | Moderate | Evidence based on a single study |
Ergot alkaloids | ||||||
 Liabsuetrakul 2007 [33] Oral or intravenous ergot alkaloids versus no uterotonics | 7 per 1000 | 2 per 1000 (1 to 9) | RR 0.33 (0.08–1.40) | 1868 (3 studies) | Low | Serious risk of bias, serious imprecision |
Tranexamic acid | ||||||
 Heesen 2014 [58] Tranexamic acids versus placebo | 53 per 1000 | 18 per 1000 (11 to 32) | RR 0.34 (0.20–0.60) | 1662 (6 studies) | Moderate | Serious imprecision |
 Novikova 2015 [59] Tranexamic acids versus placebo or no treatment | 31 per 1000 | 7 per 1000 (3 to 16) | RR 0.24 (0.11–0.53) | 1698 (6 studies) | Moderate | Serious imprecision |
 Ker 2016 [60] Tranexamic acids versus placebo or no treatment | 44 per 1000 | 14 per 1000 (8 to 23) | RR 0.31 (0.18–0.53) | 2272 (9 studies) | Low | Serious risk of bias, serious imprecision |
Timing of cord clamping | ||||||
 McDonald, 2013 [22] Early versus late cord clamping | 15 per 1000 | 15 per 1000 (7 to 35) | RR 1.02 (0.44–2.37) | 1345 (3 studies) | Moderate | Serious imprecision |
Uterine massage | ||||||
 Hofmeyr 2013 [61] Uterine massage before placental delivery versus no massage | 6 per 1000 | 6 per 1000 (2 to 23) | RR 0.97 (0.26–3.58) | 1257 (2 studies) | Low | Serious inconsistency, serious imprecision |
 Hofmeyr 2013 [61] Uterine massage before and after placental delivery versus no massage | 6 per 1000 | 5 per 1000 (1 to 20) | RR 0.97 (0.26–3.58) | 1457 (3 studies) | Low | Serious inconsistency, serious imprecision |