Cochrane · systematic review · CD007412

Active versus expectant management for women in the third stage of labour

Begley, CM, Gyte, GML, Devane, D, et al. · Cochrane Database of Systematic Reviews · 2019 · Cochrane Library

Pregnancy and Childbirth3 versionsAMSTAR 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
7
current version
GRADE rated
4
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 3 · 42.9%Very low 2 · 28.6%Low 2 · 28.6%Moderate 0 · 0%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

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Active versus expectant management of the third stage of labour (all women)

Population: all women who expected a vaginal birth at 24 weeks' gestation or later and their babies
7 questions
OutcomeEffectEvidenceStatus / GRADE
Severe primary PPH (clinically estimated or measured blood loss ≥ 1000 mL at time of birth)
Active vs expectant management of the third stage of labour (all women)
RR 0.34 [0.14, 0.87]3 studies · 4636 participantsVery low
Downgraded: risk of bias, imprecision, inconsistency, indirectness, publication bias
Very severe primary PPH (clinically estimated or measured blood loss ≥ 2500 mL at time of birth)
Active vs expectant management of the third stage of labour (all women)
no estimate extracted0 studies · 0 participantsUngraded
Maternal mortality
Active vs expectant management of the third stage of labour (all women)
no estimate extracted0 studies · 0 participantsUngraded
Maternal Hb < 9 g/dL 24‐72 hours postpartum
Active vs expectant management of the third stage of labour (all women)
RR 0.5 [0.3, 0.83]2 studies · 1572 participantsLow
Downgraded: risk of bias, imprecision, inconsistency, indirectness, publication bias
Admission to SCBU/NICU
Active vs expectant management of the third stage of labour (all women)
RR 0.81 [0.6, 1.11]2 studies · 3207 participantsLow
Downgraded: risk of bias, imprecision, inconsistency, indirectness, publication bias
Neonatal jaundice requiring phototherapy or exchange transfusion
Active vs expectant management of the third stage of labour (all women)
RR 0.96 [0.55, 1.68]2 studies · 3142 participantsVery low
Downgraded: risk of bias, imprecision, inconsistency, indirectness, publication bias
Neonatal polycythaemia treated with dilutional exchange transfusion
Active vs expectant management of the third stage of labour (all women)
no estimate extracted0 studies · 0 participantsUngraded