Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

22 questions · 22 findings · 3 reviews · Pregnancy and Childbirth

No studies found 0 · 0%GRADE not reported 1 · 4.5%Very low 3 · 13.6%Low 8 · 36.4%Moderate 5 · 22.7%High 5 · 22.7%

Early initiation of epidural analgesia vs Late initiation

Caesarean section · pregnant women (at term) requesting epidural analgesia in labour (regardless of whether the labour was spontaneous or induced)

Early initiation of epidural analgesia showed no clear difference in caesarean section compared with late initiation (high certainty).

1 finding from 1 review

Early initiation of epidural analgesia vs Late initiation

Instrumental delivery · pregnant women (at term) requesting epidural analgesia in labour (regardless of whether the labour was spontaneous or induced)

Early initiation of epidural analgesia showed no clear difference in instrumental delivery compared with late initiation (high certainty).

1 finding from 1 review

Early initiation of epidural analgesia vs Late initiation

Apgar score less than 7 at 5 minutes · pregnant women (at term) requesting epidural analgesia in labour (regardless of whether the labour was spontaneous or induced)

Early initiation of epidural analgesia showed no clear difference in apgar score <7 at 5 min compared with late initiation (high certainty).

1 finding from 1 review

Combined spinal‐epidural vs high‐dose spinal

Number of women requiring a repeat regional block or a general anaesthetic as a result of failure to establish adequate initial blockade · women undergoing caesarean section

Combined spinal‐epidural showed no clear difference in number of women requiring a repeat regional block or a general… compared with high‐dose spinal (low certainty).

1 finding from 1 review

Combined spinal‐epidural vs high‐dose spinal

Number of women requiring supplemental intra‐operative analgesia at any time after CSE or spinal anaesthetic insertion · women undergoing caesarean section

It is very uncertain whether combined spinal‐epidural changes number of women requiring supplemental intra‐operative analgesia at… compared with high‐dose spinal (very low certainty).

1 finding from 1 review

Combined spinal‐epidural vs high‐dose spinal

Number of women requiring intra‐operative conversion to general anaesthesia · women undergoing caesarean section

It is very uncertain whether combined spinal‐epidural changes number of women requiring intra‐operative conversion to general… compared with high‐dose spinal (very low certainty).

1 finding from 1 review

Combined spinal‐epidural vs low‐dose spinal

Number of women requiring a repeat regional block or a general anaesthetic as a result of failure to establish adequate initial blockade · women undergoing caesarean section

Combined spinal‐epidural showed no clear difference in number of women requiring a repeat regional block or a general… compared with low‐dose spinal (low certainty).

1 finding from 1 review

Combined spinal‐epidural vs low‐dose spinal

Number of women requiring supplemental intra‐operative analgesia at any time after CSE or spinal anaesthetic insertion · women undergoing caesarean section

Combined spinal‐epidural showed no clear difference in number of women requiring supplemental intra‐operative analgesia at… compared with low‐dose spinal (moderate certainty).

1 finding from 1 review