WHO guidelines for the management of postpartum haemorrhage ...
WHO guidelines for the management of postpartum haemorrhage ...
WHO guidelines for the management of postpartum haemorrhage ...
You also want an ePaper? Increase the reach of your titles
YUMPU automatically turns print PDFs into web optimized ePapers that Google loves.
<strong>WHO</strong> <strong>guidelines</strong> <strong>for</strong> <strong>the</strong> <strong>management</strong> <strong>of</strong> <strong>postpartum</strong> <strong>haemorrhage</strong> and retained placenta<br />
B. Management <strong>of</strong> atonic PPH<br />
Table B1. Adjunct use <strong>of</strong> misoprostol in women who received prophylactic oxytocin in <strong>the</strong> third stage <strong>of</strong> labour (34)<br />
No. <strong>of</strong><br />
studies<br />
Quality assessment<br />
Design Limitations Inconsistency Indirectness Imprecision<br />
Additional blood loss ≥500 ml<br />
4<br />
Randomized<br />
trial<br />
No serious<br />
limitations<br />
Additional blood loss ≥1000 ml<br />
3<br />
Randomized<br />
trial<br />
Blood transfusion<br />
4<br />
Hysterectomy<br />
3<br />
Randomized<br />
trial<br />
Randomized<br />
trial<br />
Additional uterotonics<br />
3<br />
Shivering<br />
4<br />
Randomized<br />
trial<br />
Randomized<br />
trial<br />
No serious<br />
limitations<br />
No serious<br />
limitations<br />
No serious<br />
limitations<br />
No serious<br />
limitations<br />
No serious<br />
limitations<br />
No serious<br />
inconsistency<br />
No serious<br />
inconsistency<br />
No serious<br />
inconsistency<br />
No serious<br />
inconsistency<br />
No serious<br />
inconsistency<br />
No serious<br />
inconsistency<br />
No serious<br />
indirectness<br />
No serious<br />
indirectness<br />
No serious<br />
indirectness<br />
No serious<br />
indirectness<br />
No serious<br />
indirectness<br />
No serious<br />
indirectness<br />
No serious<br />
imprecision<br />
O<strong>the</strong>r<br />
considerations<br />
None<br />
Serious 1 None<br />
No serious<br />
imprecision<br />
None<br />
Very serious 1 None<br />
No serious<br />
imprecision<br />
None<br />
Serious 1 None<br />
Summary <strong>of</strong> findings<br />
No. <strong>of</strong> patients Effect<br />
Primary<br />
outcomes<br />
170/929<br />
(18.3%)<br />
20/899<br />
(2.2%)<br />
138/927<br />
(14.9%)<br />
5/900<br />
(0.6%)<br />
253/894<br />
(28.3%)<br />
556/928<br />
(59.9%)<br />
Controls<br />
200/950<br />
(21.1%)<br />
27/915<br />
(3.1%)<br />
147/949<br />
(14.5%)<br />
5/919<br />
(0.4%)<br />
271/910<br />
(28.3%)<br />
270/948<br />
(17.7%)<br />
Relative<br />
(95% CI)<br />
RR 0.83<br />
(0.64–<br />
1.07)<br />
RR 0.76<br />
(0.43–<br />
1.34)<br />
RR 0.96<br />
(0.77–<br />
1.19)<br />
RR 0.93<br />
(0.16–<br />
5.41)<br />
RR 0.96<br />
(0.84–1.1)<br />
RR 2.24<br />
(1.72–<br />
2.91)<br />
Absolute<br />
Quality<br />
29 fewer<br />
per 1000 High<br />
7 fewer<br />
per 1000 Moderate<br />
6 fewer<br />
per 1000 High<br />
0 fewer<br />
per 1000 Low<br />
11 fewer<br />
per 1000 High<br />
219 more<br />
per 1000 Moderate<br />
1<br />
Wide confidence interval.<br />
Importance<br />
Critical<br />
Critical<br />
Critical<br />
Critical<br />
Critical<br />
Important<br />
28
Change language