Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

954 questions · 963 findings · 130 reviews · Headline outcomes only

No studies found 181 · 18.8%GRADE not reported 71 · 7.4%Very low 163 · 16.9%Low 311 · 32.3%Moderate 163 · 16.9%High 74 · 7.7%

Planned elective birth (induction or caesarean) vs expectant management

Serious maternal morbidity or death · pregnant women with gestational diabetes, between 38 ‐ 39 gestational weeks, without other maternal or fetal conditions.

It is very uncertain whether planned elective birth (induction or caesarean) changes maternal mortality or serious maternal morbidity compared with expectant management (very low certainty).

1 finding from 1 review

Planned elective birth (induction or caesarean) vs expectant management

Caesarean section · pregnant women with gestational diabetes, between 38 ‐ 39 gestational weeks, without other maternal or fetal conditions.

It is very uncertain whether planned elective birth (induction or caesarean) changes caesarean section compared with expectant management (very low certainty).

1 finding from 1 review

Planned elective birth (induction or caesarean) vs expectant management

Instrumental vaginal birth · pregnant women with gestational diabetes, between 38 ‐ 39 gestational weeks, without other maternal or fetal conditions.

It is very uncertain whether planned elective birth (induction or caesarean) changes instrumental vaginal birth compared with expectant management (very low certainty).

1 finding from 1 review

Planned elective birth (induction or caesarean) vs expectant management

Shoulder dystocia · pregnant women with gestational diabetes, between 38 ‐ 39 gestational weeks, without other maternal or fetal conditions.

It is very uncertain whether planned elective birth (induction or caesarean) changes shoulder dystocia compared with expectant management (very low certainty).

1 finding from 1 review

Planned elective birth (induction or caesarean) vs expectant management

Large‐for‐gestational age · pregnant women with gestational diabetes, between 38 ‐ 39 gestational weeks, without other maternal or fetal conditions.

Planned elective birth (induction or caesarean) showed no clear difference in large‐for‐gestational age compared with expectant management (low certainty).

1 finding from 1 review

Planned elective birth (induction or caesarean) vs expectant management

Acidaemia ‐ not measured · pregnant women with gestational diabetes, between 38 ‐ 39 gestational weeks, without other maternal or fetal conditions.

The review found no eligible studies for this question.

1 finding from 1 review

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

Severe perineal/vaginal trauma · Women in labour where operative delivery was not anticipated. (Women were above 16 years old and between 28 gestational weeks and full…

Selective may leads to lower severe perineal/vaginal trauma 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

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