Summary of findings for the main comparison. Beta stimulant compared with placebo for helping to turn babies with breech presentation when ECV was used.
| Beta stimulant compared with placebo for helping to turn babies with breech presentation when ECV was used | ||||||
| Patient or population: patients with breech presentation Settings: studies in hospital settings Intervention: beta stimulant Comparison: placebo | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | Number of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Placebo | Beta stimulant | |||||
| Cephalic presentation at birth (primary) | Study population | RR 1.68 (1.14 to 2.48) | 459 (5 studies) | ⊕⊕⊝⊝ Low1,2 | ||
| 294 per 1000 | 494 per 1000 (335 to 729) | |||||
| Moderate | ||||||
| 255 per 1000 | 428 per 1000 (291 to 632) | |||||
| Cephalic vaginal birth not achieved (CS + breech vaginal birth) primary outcome | Study population | RR 0.75 (0.6 to 0.92) | 399 (4 studies) | ⊕⊕⊕⊝ Moderate3 | ||
| 727 per 1000 | 545 per 1000 (436 to 669) | |||||
| Moderate | ||||||
| 708 per 1000 | 531 per 1000 (425 to 651) | |||||
| Caesarean section (primary) | Study population | RR 0.77 (0.67 to 0.88) | 742 (6 studies) | ⊕⊕⊕⊝ Moderate1 | ||
| 670 per 1000 | 516 per 1000 (449 to 590) | |||||
| Moderate | ||||||
| 707 per 1000 | 544 per 1000 (474 to 622) | |||||
| Fetal bradycardia (primary) | Study population | RR 2.81 (0.12 to 66.17) | 58 (1 study) | ⊕⊝⊝⊝ Very low4,5 | ||
| 0 per 1000 | 0 per 1000 (0 to 0) | |||||
| Moderate | ||||||
| 0 per 1000 | 0 per 1000 (0 to 0) | |||||
| Failed external cephalic version | Study population | RR 0.7 (0.6 to 0.82) | 900 (9 studies) | ⊕⊕⊕⊝ Moderate1 | ||
| 654 per 1000 | 458 per 1000 (393 to 537) | |||||
| Moderate | ||||||
| 632 per 1000 | 442 per 1000 (379 to 518) | |||||
| Perinatal mortality | See comment | See comment | Not estimable | 0 (0) | See comment | No data reported |
| Perinatal morbidity | See comment | See comment | Not estimable | 0 (0) | See comment | No data reported |
| *The basis for the assumed risk (e.g. median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk ratio. | ||||||
| GRADE Working Group grades of evidence. High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | ||||||
1. Most studies contributing data had design limitations. 2. I2 > 60%. Effect size varied considerably. 3. All studies providing data had design limitations. 4. The one study included is of poor quality, as it is an unblinded quasi‐RCT. 5. Wide 95% CI crossing the line of no effect; small sample size and low event rate.