WHO guidelines for the management of postpartum haemorrhage ...
WHO guidelines for the management of postpartum haemorrhage ...
WHO guidelines for the management of postpartum haemorrhage ...
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<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 />
Table C2. Intraumbilical vein injection <strong>of</strong> saline solution vs expectant <strong>management</strong> <strong>for</strong> retained placenta (188)<br />
Quality assessment<br />
Summary <strong>of</strong> findings<br />
No. <strong>of</strong> patients Effect<br />
No. <strong>of</strong><br />
studies<br />
Design Limitations Inconsistency Indirectness Imprecision<br />
O<strong>the</strong>r<br />
considerations<br />
Intraumbilical<br />
vein injection <strong>of</strong><br />
saline solution<br />
Expectant<br />
<strong>management</strong><br />
Relative<br />
(95% CI)<br />
Absolute<br />
Quality<br />
Manual removal <strong>of</strong> <strong>the</strong> placenta<br />
4 Randomized<br />
trial<br />
No serious<br />
limitations<br />
No serious<br />
inconsistency<br />
No serious<br />
indirectness<br />
No serious<br />
imprecision<br />
None<br />
114/206 (55.3%) 119/207 (58%)<br />
RR 0.97<br />
(0.83–1.19)<br />
17 fewer<br />
per 1000 High<br />
Blood loss ≥500 ml<br />
1 Randomized<br />
trial<br />
No serious<br />
limitations<br />
No serious<br />
inconsistency<br />
No serious<br />
indirectness<br />
Serious 1 None<br />
15/62 (24.2%) 14/60 (23.3%)<br />
RR 1.04<br />
(0.55–1.96)<br />
9 more<br />
per 1000 Moderate<br />
Blood loss ≥1000 ml<br />
1 Randomized<br />
trial<br />
No serious<br />
limitations<br />
No serious<br />
inconsistency<br />
No serious<br />
indirectness<br />
Serious 2 None<br />
3/62 (4.8%) 4/60 (7%)<br />
RR 0.73<br />
(0.17–3.11)<br />
18 fewer<br />
per 1000 Moderate<br />
Blood transfusion<br />
2 Randomized<br />
trial<br />
No serious<br />
limitations<br />
Serious 3 No serious<br />
indirectness<br />
Serious 4 None<br />
15/118 (12.7%) 19/110 (17%)<br />
RR 0.76<br />
(0.41–1.39)<br />
40 fewer<br />
per 1000 Low<br />
1<br />
Anything from a 45% reduction to a tw<strong>of</strong>old increase.<br />
2<br />
Anything from an 83% reduction to a threefold increase.<br />
3<br />
No events in one trial.<br />
4<br />
Anything from a 59% reduction to a 39% increase.<br />
Importance<br />
Critical<br />
Critical<br />
Critical<br />
Critical<br />
34
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