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 C5. Intraumbilical vein injection <strong>of</strong> 50 IU oxytocin+30 ml saline vs placebo <strong>for</strong> retained placenta (189)<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 vein<br />
injection <strong>of</strong> 50 IU<br />
oxytocin in saline<br />
Placebo<br />
Relative<br />
(95% CI)<br />
Absolute<br />
Manual removal <strong>of</strong> <strong>the</strong> placenta<br />
1 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 />
179/292 (61.3%)<br />
177/285<br />
(62.1%)<br />
RR 0.98<br />
(0.87–<br />
1.12)<br />
12 fewer per<br />
1000 (from 81<br />
fewer to 75<br />
more)<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 />
99/292 (33.9%)<br />
99/285<br />
(34.7%)<br />
RR 0.98<br />
(0.78–<br />
1.23)<br />
7 fewer per<br />
1000 (from 76<br />
fewer to 80<br />
more)<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 />
31/292 (10.6%)<br />
28/285<br />
(9.8%)<br />
RR 1.09<br />
(0.67–<br />
1.76)<br />
9 more per<br />
1000 (from 32<br />
fewer to 74<br />
more)<br />
Blood transfusion<br />
1 randomized<br />
trial<br />
No serious<br />
limitations<br />
No serious<br />
inconsistency<br />
No serious<br />
indirectness<br />
Serious 3 None<br />
43/292 (14.7%)<br />
36/285<br />
(12.6%)<br />
RR 0.77<br />
(0.46–<br />
1.26)<br />
29 fewer per<br />
1000 (from 68<br />
fewer to 33<br />
more)<br />
1<br />
Anything from a 22% reduction to a 23% increase.<br />
2<br />
Anything from a 33% reduction to a 76% increase.<br />
3<br />
Anything from a 54% reduction to a 26% increase.<br />
Quality<br />
High<br />
Moderate<br />
Moderate<br />
Moderate<br />
Importance<br />
Critical<br />
Critical<br />
Critical<br />
Critical<br />
37
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