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Evidence found and GRADE certainty

374 questions · 377 findings · 63 reviews · Pregnancy and Childbirth

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No studies found 88 · 23.3%GRADE not reported 32 · 8.5%Very low 92 · 24.4%Low 103 · 27.3%Moderate 50 · 13.3%High 12 · 3.2%

Upright position vs recumbent position

Operative birth (caesarean or instrumental vaginal) · women in the second stage of labour with epidural anaesthesia

Upright position leads to higher operative birth (caesarean or instrumental vaginal) compared with recumbent position (sensitivity analyses ‐ studies at low risk of… (high certainty).

1 finding from 1 review

Upright position vs recumbent position

Instrumental vaginal birth · women in the second stage of labour with epidural anaesthesia

Upright position showed no clear difference in instrumental vaginal birth compared with recumbent position (sensitivity analyses ‐ studies at low risk of… (low certainty).

1 finding from 1 review

Standard care plus IV tranexamic acid vs placebo or usual care

Maternal mortality due to bleeding · women with primary postpartum haemorrhage following vaginal or caesarean birth

Standard care plus IV tranexamic acid showed no clear difference in maternal mortality due to bleeding compared with placebo or standard care alone (moderate certainty).

1 finding from 1 review

Standard care plus IV tranexamic acid vs placebo or usual care

Maternal mortality ‐ not reported · women with primary postpartum haemorrhage following vaginal or caesarean birth

Standard care plus IV tranexamic acid showed no clear difference in maternal mortality (all causes) compared with placebo or standard care alone (moderate certainty).

1 finding from 1 review

Standard care plus IV tranexamic acid vs placebo or usual care

Serious maternal morbidity · women with primary postpartum haemorrhage following vaginal or caesarean birth

Standard care plus IV tranexamic acid showed no clear difference in serious maternal morbidity (any) compared with placebo or standard care alone (high certainty).

1 finding from 1 review

Standard care plus IV tranexamic acid vs placebo or usual care

Maternal blood loss of 500 mL or greater · women with primary postpartum haemorrhage following vaginal or caesarean birth

Standard care plus IV tranexamic acid may leads to lower blood loss 500 mL or more after randomisation compared with placebo or standard care alone (low certainty).

1 finding from 1 review

Standard care plus IV tranexamic acid vs placebo or usual care

Blood transfusion · women with primary postpartum haemorrhage following vaginal or caesarean birth

Standard care plus IV tranexamic acid showed no clear difference in blood transfusion (any) compared with placebo or standard care alone (moderate certainty).

1 finding from 1 review

Standard care plus IV tranexamic acid vs placebo or usual care

Hysterectomy to control bleeding · women with primary postpartum haemorrhage following vaginal or caesarean birth

Standard care plus IV tranexamic acid showed no clear difference in surgical intervention to control bleeding: Hysterectomy compared with placebo or standard care alone (high certainty).

1 finding from 1 review

Standard care plus IV tranexamic acid vs placebo or usual care

Side effects of the intervention: Any maternal vascular occlusive event · women with primary postpartum haemorrhage following vaginal or caesarean birth

Standard care plus IV tranexamic acid showed no clear difference in side effects of the intervention: Any maternal vascular occlusive… compared with placebo or standard care alone (moderate certainty).

1 finding from 1 review