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 C3. Intraumbilical vein injection <strong>of</strong> saline + oxytocin 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<br />
with saline +<br />
oxytocin<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 />
5 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 />
117/234 (50%) 129/220 (59%)<br />
RR 0.86<br />
(0.72–1.01)<br />
82 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 />
25/70 (35.7%) 14/60 (23%)<br />
RR 1.53<br />
(0.78–2.67)<br />
121 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 />
6/70 (8.6%) 4/60 (6.7%)<br />
RR 1.29<br />
(0.38–4.34)<br />
19 more<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 />
18/120 (15%) 19/117 (16%)<br />
RR 0.89<br />
(0.5–1.58)<br />
17 fewer<br />
per 1000 Low<br />
1<br />
Anything from a 22% reduction to a threefold increase.<br />
2<br />
Anything from a 62% reduction to a more than fourfold increase.<br />
3<br />
No events in one trial.<br />
4<br />
Anything from a 50% reduction to a 58% increase.<br />
Importance<br />
Critical<br />
Critical<br />
Critical<br />
Critical<br />
35
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