Summary of findings 2. Regional analgesia (with tocolysis) versus no intervention of regional analgesia (with or without tocolysis) for breech presentation.
| Regional analgesia (with tocolysis) versus no intervention of regional analgesia (with or without tocolysis) for breech presentation | ||||||
| Patient or population: patients with breech presentation Settings: studies in hospital settings Intervention: regional analgesia (with tocolysis) versus no intervention of regional analgesia (with or without tocolysis) | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | Number of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Control | Regional analgesia (with tocolysis) vs no intervention of regional analgesia (with or without tocolysis) | |||||
| Cephalic presentation at birth (primary) | Study population | RR 1.63 (0.75 to 3.53) | 279 (3 studies) | ⊕⊝⊝⊝ Very low1,2,3 | ||
| 393 per 1000 | 640 per 1000 (295 to 1000) | |||||
| Moderate | ||||||
| 352 per 1000 | 574 per 1000 (264 to 1000) | |||||
| Cephalic vaginal birth not achieved (CS + breech vaginal birth) (primary) | Study population | RR 0.65 (0.47 to 0.89) | 108 (1 study) | ⊕⊕⊝⊝ Low4,5 | ||
| 741 per 1000 | 481 per 1000 (348 to 659) | |||||
| Moderate | ||||||
| 741 per 1000 | 482 per 1000 (348 to 659) | |||||
| Caesarean section (primary) | Study population | RR 0.74 (0.4 to 1.37) | 279 (3 studies) | ⊕⊝⊝⊝ Very low1,2,3 | ||
| 650 per 1000 | 481 per 1000 (260 to 891) | |||||
| Moderate | ||||||
| 685 per 1000 | 507 per 1000 (274 to 938) | |||||
| Fetal bradycardia (primary) | Study population | RR 1.48 (0.62 to 3.57) | 210 (2 studies) | ⊕⊕⊝⊝ Low1,3 | ||
| 85 per 1000 | 126 per 1000 (53 to 303) | |||||
| Moderate | ||||||
| 86 per 1000 | 127 per 1000 (53 to 307) | |||||
| Failed external cephalic version | Study population | RR 0.61 (0.43 to 0.86) | 409 (5 studies) | ⊕⊕⊕⊝ Moderate1 | ||
| 585 per 1000 | 357 per 1000 (251 to 503) | |||||
| Moderate | ||||||
| 577 per 1000 | 352 per 1000 (248 to 496) | |||||
| Perinatal morbidity | See comment | See comment | Not estimable | 0 (0) | See comment | No data reported |
| Perinatal mortality | 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. All studies contributing data had design limitations. 2. I2 > 60%; direction and size of effect inconsistent. 3. Wide 95% CI crossing the line of no effect and small sample size. 4. Study contributing data had design limitations. 5. Estimate based on small sample size.