Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

1,773 questions · 1,817 findings · 212 reviews · Headline outcomes only

No studies found 383 · 21.1%GRADE not reported 192 · 10.6%Very low 472 · 26%Low 444 · 24.4%Moderate 228 · 12.5%High 98 · 5.4%

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).

2 findings from 1 review

Upright position vs recumbent position

Caesarean section · women in the second stage of labour with epidural anaesthesia

Upright position leads to higher caesarean section compared with recumbent position (sensitivity analyses ‐ studies at low risk of… (high certainty).

2 findings 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).

2 findings from 1 review

Upright position vs recumbent position

Blood loss (greater than 500 mL) (trial authors defined it as PPH requiring blood transfusion) · women in the second stage of labour with epidural anaesthesia

Upright position showed no clear difference in blood loss (greater than 500 mL) (trial authors defined it as PPH… compared with recumbent position (moderate certainty).

1 finding from 1 review

Upright position vs recumbent position

Abnormal fetal heart rate patterns, requiring intervention · women in the second stage of labour with epidural anaesthesia

It is very uncertain whether upright position changes abnormal fetal heart rate patterns, requiring intervention compared with recumbent position (very low certainty).

1 finding from 1 review

Summary of findings TIVA vs inhalational maintenance of anaesthesia

Postoperative delirium (One study used DRS, three studies used CAM and in one study diagnostic tool was not reported) Time points were up to 4 days postoperatively

It is very uncertain whether summary of findings TIVA changes postoperative delirium (One study used DRS, three studies used CAM… compared with inhalational maintenance of anaesthesia (very low certainty).

1 finding from 1 review