Summary of findings for the main comparison. prostaglandins for retained placenta.
| Prostaglandins for retained placenta | ||||||
| Patient or population: women with retained placenta Settings: all care setting Intervention: prostaglandins | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Control | Prostaglandins | |||||
| Manual removal of placenta Manual removal after intervention Follow‐up: 30‐45 minutes | Study population | RR 0.82 (0.54 to 1.27) | 244 (3 studies) | ⊕⊝⊝⊝ very low1,2,3 | ||
| 561 per 1000 | 460 per 1000 (303 to 712) | |||||
| Low | ||||||
| 10 per 1000 | 8 per 1000 (5 to 13) | |||||
| High | ||||||
| 30 per 1000 | 25 per 1000 (16 to 38) | |||||
| Severe postpartum haemorrhage Objectively or subjectively measured after intervention/Estimated blood loss in ML. Follow‐up: 30‐45 minutes | Study population | RR 0.80 (0.55 to 1.15) | 194 (2 studies) | ⊕⊝⊝⊝ very low3,4 | ||
| 432 per 1000 | 346 per 1000 (238 to 497) | |||||
| Low | ||||||
| 30 per 1000 | 24 per 1000 (17 to 34) | |||||
| High | ||||||
| 100 per 1000 | 80 per 1000 (55 to 115) | |||||
| Blood transfusion Blood transfusion during puerperium Follow‐up: 1 to 8 weeks | Study population | RR 0.72 (0.43 to 1.22) | 244 (3 studies) | ⊕⊝⊝⊝ very low3,4 | ||
| 224 per 1000 | 161 per 1000 (96 to 274) | |||||
| Low | ||||||
| 60 per 1000 | 43 per 1000 (26 to 73) | |||||
| High | ||||||
| 130 per 1000 | 94 per 1000 (56 to 159) | |||||
| Mean blood loss Objectively or subjectively measured after intervention/Mean blood loss in ML. Follow‐up: 30 to 45 minutes | The mean blood loss in the control groups was 0 millilitres | The mean blood loss in the intervention groups was 205.26 lower (536.31 lower to 125.79 higher) | 244 (3 studies) | ⊕⊝⊝⊝ very low1,5,6 | ||
| Mean time from injection to placenta removal Mean time from injection to placenta removal. Follow‐up: 30 to 45 minutes | The mean time from injection to placenta removal in the control groups was minutes | The mean time from injection to placenta removal in the intervention groups was 7.0 lower (21.2 lower to 7.2 higher) | 99 (1 study) | ⊕⊝⊝⊝ very low1,6 | ||
| Maternal pain between injection and discharge from labour ward Maternal pain between injection and discharge from labour ward Follow‐up: 1 to 24 hours | Study population | RR 0.91 (0.43 to 1.96) | 124 (2 studies) | ⊕⊝⊝⊝ very low1,3 | ||
| 172 per 1000 | 157 per 1000 (74 to 338) | |||||
| Low | ||||||
| 100 per 1000 | 91 per 1000 (43 to 196) | |||||
| High | ||||||
| 200 per 1000 | 182 per 1000 (86 to 392) | |||||
| Nausea between injection and discharge from labour ward Nausea between injection and discharge from labour ward Follow‐up: 1 to 24 hours | Study population | RR 1.72 (0.15 to 19.41) | 124 (2 studies) | ⊕⊝⊝⊝ very low1,2,6 | ||
| 34 per 1000 | 59 per 1000 (5 to 669) | |||||
| Low | ||||||
| 30 per 1000 | 52 per 1000 (5 to 582) | |||||
| High | ||||||
| 100 per 1000 | 172 per 1000 (15 to 1000) | |||||
| *The basis for the assumed risk (e.g. the 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 Failure to adherence to intention‐to‐treat principle. Selective reporting. Stopping early for benefit. 2 Large variation in effect. Confidence intervals overlap.Substantial heterogeneity. 3 Few women and outcome events. Confidence interval include null effect, include appreciable harm or benefit. Not optimal information size. 4 Lack of blinding. Failure to adherence to intention‐to‐treat principle. Selective reporting. Stopping early for benefit. 5 Large variation in effect. Confidence intervals do not overlap. Substantial heterogeneity. 6 Few women. Confidence interval includes null effect, include appreciable harm or benefit. Not optimal information size.