WHO guidelines for the management of postpartum haemorrhage ...

WHO guidelines for the management of postpartum haemorrhage and retained placenta
A. Diagnosis of PPH
Table A1. Visual versus quantitative methods for estimating blood loss after vaginal delivery (3)
No. of
studies
Quality assessment
Design Limitations Inconsistency Indirectness Imprecision
Other
considerations
Summary of findings
No. of patients Effect
Visual
estimation
Measured
estimation
Relative
(95% CI)
Absolute
Quality
Mean blood loss
1 Randomized
trial
Serious 1 No serious
inconsistency
Serious 2 Serious 3 Reporting bias 4 61 62 – Mean difference
– 99.71 (–157.19 to
–42.23)
Very
low
1
Method of allocation concealment not described.
2
Related to settings where it is feasible to use the drape method.
3
Wide range.
4
Intervention not blinded.
Table A2. Training courses on estimating blood loss after vaginal delivery (13)
Quality assessment
No. of subjects making
accurate estimation
Summary of findings
Effect
No. of
studies
Design Limitations Inconsistency Indirectness Imprecision
Other
considerations
Attending
training
course on
blood loss
estimation
Controls
Relative
(95% CI)
Absolute
Quality
Blood loss estimated accurately
1 Randomized
trial
Serious 1 No serious
inconsistency
Serious 2 Serious 3 None 34/45
(75.6%)
11/45
(24%)
RR 3.09
(1.80–5.30)
522 more
per 1000 4 Very low
1
Methods of randomization and allocation concealment not described.
2
Limited to setting; may be difficult to generalize.
3
Wide confidence intervals.
4
522 more cases per 1000 accurately estimated.
Importance
Important
Importance
Not important
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