Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

880 questions · 912 findings · 126 reviews · Headline outcomes only

No studies found 143 · 15.7%GRADE not reported 38 · 4.2%Very low 250 · 27.4%Low 253 · 27.7%Moderate 168 · 18.4%High 60 · 6.6%

Selective vs routine episiotomy: all vaginal births where operative vaginal delivery was not anticipated

Perineal infection · Women in labour where operative delivery was not anticipated. (Women were above 16 years old and between 28 gestational weeks and full…

Selective showed no clear difference in perineal infection compared with routine episiotomy: all vaginal births where operative vaginal… (low certainty).

1 finding from 1 review

Selective vs routine episiotomy: all vaginal births where operative vaginal delivery was not anticipated

Women with moderate or severe pain (measured by visual analogue scale) · Women in labour where operative delivery was not anticipated. (Women were above 16 years old and between 28 gestational weeks and full…

It is very uncertain whether selective changes women with moderate or severe pain (measured by visual analogue scale) compared with routine episiotomy: all vaginal births where operative vaginal… (very low certainty).

1 finding from 1 review

Selective vs routine episiotomy: all vaginal births where operative vaginal delivery was not anticipated

Women with long‐term dyspareunia (≥ 6 months) · Women in labour where operative delivery was not anticipated. (Women were above 16 years old and between 28 gestational weeks and full…

Selective showed no clear difference in women with long‐term dyspareunia (≥ 6 months) compared with routine episiotomy: all vaginal births where operative vaginal… (moderate certainty).

1 finding from 1 review

Selective vs routine episiotomy: all vaginal births where operative vaginal delivery was not anticipated

Women with long‐term urinary incontinence (≥ 6 months) · Women in labour where operative delivery was not anticipated. (Women were above 16 years old and between 28 gestational weeks and full…

Selective showed no clear difference in women with long‐term urinary incontinence (≥ 6 months) compared with routine episiotomy: all vaginal births where operative vaginal… (low certainty).

1 finding from 1 review

Manual fundal pressure vs no fundal pressure

No spontaneous vaginal birth within a specified time · women with singleton pregnancy in vertex position in second stage of labour

It is very uncertain whether manual fundal pressure changes no spontaneous vaginal birth within a specified time, as defined by… compared with no fundal pressure (very low certainty).

1 finding from 1 review

Fundal pressure by inflatable belt vs no fundal pressure

Apgar score less than 7 at 5 minutes · women with singleton pregnancy in vertex position in second stage of labour

It is very uncertain whether fundal pressure by inflatable belt changes apgar score less than 7 after 5 minutes compared with no fundal pressure (very low certainty).

1 finding from 1 review

Manual fundal pressure vs no fundal pressure

Operative birth (caesarean or instrumental vaginal) · women with singleton pregnancy in vertex position in second stage of labour

It is very uncertain whether manual fundal pressure changes operative birth ‐ Instrumental or caesarean birth compared with no fundal pressure (very low certainty).

1 finding from 1 review

Manual fundal pressure vs no fundal pressure

Apgar score less than 7 at 5 minutes · women with singleton pregnancy in vertex position in second stage of labour

It is very uncertain whether manual fundal pressure changes APGAR score less than 7 at 5 minutes compared with no fundal pressure (very low certainty).

1 finding from 1 review