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
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
Current version onlyActive 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
| Outcome | Effect | Evidence | Status / 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 participants | Very 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 extracted | 0 studies · 0 participants | Ungraded |
Maternal mortality Active vs expectant management of the third stage of labour (all women) | no estimate extracted | 0 studies · 0 participants | Ungraded |
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 participants | Low 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 participants | Low 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 participants | Very 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 extracted | 0 studies · 0 participants | Ungraded |
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
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Severe primary postpartum haemorrhage (PPH) (clinically estimated or measured blood loss ≥ to 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 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Very severe primary PPH (clinically estimated or measured blood loss ≥ to 2500 mL at time of birth) Active vs expectant management of the third stage of labour (all women) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Maternal mortality Active vs expectant management of the third stage of labour (all women) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Maternal Hb < 9 g/dL 24 to 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 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness, publication bias |
Admission to neonatal special/intensive care Active vs expectant management of the third stage of labour (all women) | RR 0.81 [0.6, 1.11] | 2 studies · 3207 participants | Low 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 participants | Very 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 extracted | 0 studies · 0 participants | Ungraded |
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
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Severe primary postpartum haemorrhage (PPH) (clinically estimated or measured blood loss ≥ to 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 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Very severe primary PPH (clinically estimated or measured blood loss ≥ to 2500 mL at time of birth) Active vs expectant management of the third stage of labour (all women) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Maternal mortality Active vs expectant management of the third stage of labour (all women) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Maternal Hb < 9 g/dL 24 to 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 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness, publication bias |
Admission to neonatal special/intensive care Active vs expectant management of the third stage of labour (all women) | RR 0.81 [0.6, 1.11] | 2 studies · 3207 participants | Low 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 participants | Very 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 extracted | 0 studies · 0 participants | Ungraded |