Cochrane · systematic review · CD001337
Umbilical vein injection for management of retained placenta
Kumar, N, Jahanfar, S, Haas, DM, et al. · Cochrane Database of Systematic Reviews · 2021 · Cochrane Library
Pregnancy and ChildbirthAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
28
current version
GRADE rated
22
No studies
6
Included studies
NR
No studies 6 · 21.4%Ungraded 0 · 0%Very low 13 · 46.4%Low 5 · 17.9%Moderate 4 · 14.3%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Saline solution compared to expectant management for management of retained placenta
Population: management of retained placenta
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Manual removal of the placenta Saline solution vs expectant management | RR 0.93 [0.8, 1.1] | 5 studies · 445 participants | Moderate Downgraded: risk of bias |
Maternal mortality Saline solution vs expectant management | no estimate extracted | 2 studies · 87 participants | Very low Downgraded: risk of bias, imprecision |
Severe PPH (≥ 1000 mL) Saline solution vs expectant management | RR 0.73 [0.17, 3.11] | 1 study · 122 participants | Very low Downgraded: risk of bias, imprecision |
Blood transfusion Saline solution vs expectant management | RR 0.41 [0.1, 1.73] | 3 studies · 277 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Addition of therapeutic uterotonics Saline solution vs expectant management | no estimate extracted | NR | No studies |
Need for treatment with antibiotics (infection) Saline solution vs expectant management | RR 0.48 [0.09, 2.54] | 1 study · 176 participants | Very low Downgraded: risk of bias, imprecision |
Maternal postpartum anaemia (haemoglobin 24–48 hours postpartum) Saline solution vs expectant management | no estimate extracted | 1 study · 163 participants | Very low Downgraded: risk of bias, imprecision |
Oxytocin solution compared to expectant management for management of retained placenta
Population: management of retained placenta
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Manual removal of the placenta Oxytocin solution vs expectant management | RR 0.73 [0.56, 0.95] | 7 studies · 546 participants | Low Downgraded: risk of bias, inconsistency |
Maternal mortality Oxytocin solution vs expectant management | no estimate extracted | 2 studies · 93 participants | Very low Downgraded: risk of bias, imprecision |
Severe PPH (≥ 1000 mL) Oxytocin solution vs expectant management | RR 1.23 [0.41, 3.74] | 2 studies · 190 participants | Very low Downgraded: risk of bias, imprecision |
Blood transfusion Oxytocin solution vs expectant management | RR 0.81 [0.47, 1.38] | 4 studies · 339 participants | Low Downgraded: risk of bias, imprecision |
Addition of therapeutic uterotonics Oxytocin solution vs expectant management | RR 0.5 [0.28, 0.88] | 1 study · 60 participants | Very low Downgraded: risk of bias, imprecision |
Need for treatment with antibiotics (infection) Oxytocin solution vs expectant management | RR 1.16 [0.32, 4.16] | 1 study · 179 participants | Very low Downgraded: risk of bias, imprecision |
Postpartum anaemia (haemoglobin 24–48 hours postpartum, g%) Oxytocin solution vs expectant management | no estimate extracted | 1 study · 166 participants | Very low Downgraded: risk of bias, imprecision |
Oxytocin solution compared to saline solution for management of retained placenta
Population: management of retained placenta
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Manual removal of the placenta Oxytocin solution vs saline solution | RR 0.82 [0.69, 0.97] | 14 studies · 1370 participants | Low Downgraded: risk of bias, inconsistency |
Maternal mortality Oxytocin solution vs saline solution | RR 2.93 [0.12, 71.59] | 5 studies · 782 participants | Low Downgraded: imprecision |
Severe PPH (≥ 1000 mL) Oxytocin solution vs saline solution | RR 1.08 [0.7, 1.68] | 4 studies · 766 participants | Moderate Downgraded: imprecision |
Blood transfusion Oxytocin solution vs saline solution | RR 1.08 [0.78, 1.49] | 7 studies · 974 participants | Moderate Downgraded: imprecision |
Addition of therapeutic uterotonics Oxytocin solution vs saline solution | RR 0.85 [0.59, 1.23] | 4 studies · 678 participants | Low Downgraded: imprecision, inconsistency |
Need for treatment with antibiotics (infection) Oxytocin solution vs saline solution | RR 1.26 [0.81, 1.96] | 2 studies · 635 participants | Moderate Downgraded: imprecision |
Maternal postpartum anaemia (haemoglobin 24–48 hours postpartum) Oxytocin solution vs saline solution | no estimate extracted | 1 study · 167 participants | Very low Downgraded: imprecision |
Oxytocin solution compared to plasma expander for management of retained placenta
Population: management of retained placenta
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Manual removal of the placenta Oxytocin solution vs plasma expander | RR 1.34 [0.97, 1.85] | 1 study · 109 participants | Very low Downgraded: risk of bias, imprecision |
Maternal mortality Oxytocin solution vs plasma expander | no estimate extracted | NR | No studies |
Severe PPH (≥ 1000 mL) Oxytocin solution vs plasma expander | RR 0.96 [0.34, 2.75] | 1 study · 109 participants | Very low Downgraded: risk of bias, imprecision |
Blood transfusion Oxytocin solution vs plasma expander | no estimate extracted | NR | No studies |
Additional therapeutic uterotonics Oxytocin solution vs plasma expander | no estimate extracted | NR | No studies |
Need for treatment with antibiotics (infection) Oxytocin solution vs plasma expander | no estimate extracted | NR | No studies |
Maternal postpartum anaemia (haemoglobin 24–48 hours postpartum) Oxytocin solution vs plasma expander | no estimate extracted | NR | No studies |