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. Author manuscript; available in PMC: 2014 May 19.
Published in final edited form as: Cochrane Database Syst Rev. 2011 Nov 9;(11):CD007412. doi: 10.1002/14651858.CD007412.pub3

Comparison 10. Active versus mixed management (uterotonic after placental delivery, immediate cord clamping and no CCT).

Outcome or subgroup title No. of studies No. of participants Statistical method Effect size
1 Severe primary PPH at time of birth (clinically estimated or measured blood loss ≥ 1000 mL) 1 1648 Risk Ratio (M-H, Random, 95% CI) 0.23 [0.09, 0.55]
   1.1 High-income setting 1 1648 Risk Ratio (M-H, Random, 95% CI) 0.23 [0.09, 0.55]
   1.2 Low-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
2 Very severe primary PPH at time of birth (clinically estimated or measured blood loss ≥ 2500 mL) 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
   2.1 High-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
   2.2 Low-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
3 Maternal mortality 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
   3.1 High-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
   3.2 Low-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
4 Maternal Hb < 9 g/dL at 24-72 hr 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
   4.1 High-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
   4.2 Low-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
5 Admission to neonatal special/ intensive care 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
   5.1 High-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
   5.2 Low-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
6 Neonatal jaundice requiring phototherapy or exchange transfusion 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
   6.1 High-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
   6.2 Low-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
7 Neonatal polycythaemia treated with dilutional exchange transfusion 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
   7.1 High-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
   7.2 Low-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
8 Severe primary PPH after placental delivery and up to 24 hours (clinically estimated or measured blood loss ≥ 1000 mL) 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
   8.1 High-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
   8.2 Low-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
9 Severe primary PPH at time of birth and up to 24 hours (clinically estimated or measured blood loss ≥1000 mL) 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
   9.1 High-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
   9.2 Low-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
10 Primary blood loss ≥ 500 mL at time of birth (clinically estimated or measured) 1 1648 Risk Ratio (M-H, Random, 95% CI) 0.53 [0.38, 0.74]
   10.1 High-income setting 1 1648 Risk Ratio (M-H, Random, 95% CI) 0.53 [0.38, 0.74]
   10.2 Low-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
11 Primary blood loss ≥ 500 mL after delivery of placenta and up to 24 hours (clinically estimated or measured) 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
   11.1 High-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
   11.2 Low-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
12 Primary blood loss ≥ 500 mL at time of birth and up to 24 hours (clinically estimated or measured) 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
   12.1 High-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
   12.2 Low-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
13 Mean maternal blood loss (mL) at time of birth (clinically estimated or measured) 0 0 Mean Difference (IV, Random, 95% CI) 0.0 [0.0, 0.0]
   13.1 High-income setting 0 0 Mean Difference (IV, Random, 95% CI) 0.0 [0.0, 0.0]
   13.2 Low-income setting 0 0 Mean Difference (IV, Random, 95% CI) 0.0 [0.0, 0.0]
14 Mean maternal blood loss (mL) after delivery of placenta and up to 24 hours (clinically estimated or measured) 0 0 Mean Difference (IV, Random, 95% CI) 0.0 [0.0, 0.0]
   14.1 High-income setting 0 0 Mean Difference (IV, Random, 95% CI) 0.0 [0.0, 0.0]
   14.2 Low-income setting 0 0 Mean Difference (IV, Random, 95% CI) 0.0 [0.0, 0.0]
15 Mean maternal blood loss (mL) at time of birth and up to 24 hours (clinically estimated or measured) 0 0 Mean Difference (IV, Random, 95% CI) 0.0 [0.0, 0.0]
   15.1 High-income setting 0 0 Mean Difference (IV, Random, 95% CI) 0.0 [0.0, 0.0]
   15.2 Low-income setting 0 0 Mean Difference (IV, Random, 95% CI) 0.0 [0.0, 0.0]
16 Maternal blood transfusion 1 1648 Risk Ratio (M-H, Random, 95% CI) 0.25 [0.03, 2.22]
   16.1 High-income setting 1 1648 Risk Ratio (M-H, Random, 95% CI) 0.25 [0.03, 2.22]
   16.2 Low-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
17 Clinical signs of severe blood loss 1 1648 Risk Ratio (M-H, Random, 95% CI) 0.25 [0.05, 1.17]
   17.1 High-income setting 1 1648 Risk Ratio (M-H, Random, 95% CI) 0.25 [0.05, 1.17]
   17.2 Low-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
18 Therapeutic uterotonics during third stage and/or within 24 hours 1 1648 Risk Ratio (M-H, Random, 95% CI) 0.45 [0.26, 0.77]
   18.1 High-income setting 1 1648 Risk Ratio (M-H, Random, 95% CI) 0.45 [0.26, 0.77]
   18.2 Low-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
19 Mean length of third stage 1 1648 Mean Difference (IV, Random, 95% CI) -10.0 [-10.24, -9.76]
   19.1 High-income setting 1 1648 Mean Difference (IV, Random, 95% CI) -10.0 [-10.24, -9.76]
   19.2 Low-income setting 0 0 Mean Difference (IV, Random, 95% CI) 0.0 [0.0, 0.0]
20 Manual removal of placenta as defined by authors 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
   20.1 High-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
   20.2 Low-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
21 Postnatal diastolic blood pressure > 90 mmHg between birth of baby and discharge from the labour ward 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
   21.1 High-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
   21.2 Low-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
22 Postnatal vomiting between birth of baby and discharge from the labour ward 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
   22.1 High-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
   22.2 Low-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
23 Any analgesia between birth of the baby and discharge from labour ward 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
   23.1 High-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
   23.2 Low-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
24 Women’s assessment of pain during third stage as reported by authors 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
   24.1 High-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
   24.2 Low-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
25 Secondary blood loss/any vaginal bleeding needing treatment (after 24 hours and up to 6 weeks) 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
   25.1 High-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
   25.2 Low-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
26 Amount of lochia either estimated or measured after 24 hours and up to discharge from hospital 0 0 Mean Difference (IV, Random, 95% CI) 0.0 [0.0, 0.0]
   26.1 High-income setting 0 0 Mean Difference (IV, Random, 95% CI) 0.0 [0.0, 0.0]
   26.2 Low-income setting 0 0 Mean Difference (IV, Random, 95% CI) 0.0 [0.0, 0.0]
27 Surgical evacuation of retained products of conception 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
   27.1 High-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
   27.2 Low-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
28 Afterpains - abdominal pain associated with the contracting uterus in the postpartum period 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
   28.1 High-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
   28.2 Low-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
29 Apgar score < 7 at 5 minutes 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
   29.1 High-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
   29.2 Low-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
30 Birthweight 0 0 Mean Difference (IV, Random, 95% CI) 0.0 [0.0, 0.0]
   30.1 High-income setting 0 0 Mean Difference (IV, Random, 95% CI) 0.0 [0.0, 0.0]
   30.2 Low-income setting 0 0 Mean Difference (IV, Random, 95% CI) 0.0 [0.0, 0.0]
31 Neonatal encephalopathy assessed using Sarnat staging (Sarnat 1976; Table 1) 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
   31.1 High-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
   31.2 Low-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
32 Neonatal mortality 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
   32.1 High-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
   32.2 Low-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
33 Intraventricular haemorrhage - Papille grade III/IV - (for infants born before 34 weeks gestation only) 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
   33.1 High-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
   33.2 Low-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
34 Number of infants who received a red blood cell transfusion 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
   34.1 High-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
   34.2 Low-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
35 Infant Hb level at 24 to 72 hours 0 0 Mean Difference (IV, Random, 95% CI) 0.0 [0.0, 0.0]
   35.1 High-income setting 0 0 Mean Difference (IV, Random, 95% CI) 0.0 [0.0, 0.0]
   35.2 Low-income setting 0 0 Mean Difference (IV, Random, 95% CI) 0.0 [0.0, 0.0]
36 Infant Hb level at 3-6 months 0 0 Mean Difference (IV, Random, 95% CI) 0.0 [0.0, 0.0]
   36.1 High-income setting 0 0 Mean Difference (IV, Random, 95% CI) 0.0 [0.0, 0.0]
   36.2 Low-income setting 0 0 Mean Difference (IV, Random, 95% CI) 0.0 [0.0, 0.0]
37 Infant iron indices (ferritin) at 3 to 6 months. 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
   37.1 High-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
   37.2 Low-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
38 Exclusive breastfeeding at discharge from hospital 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
   38.1 High-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
   38.2 Low-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
39 Neurodevelopmental, cognitive or developmental outcomes assessed after age 18 months 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
   39.1 High-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
   39.2 Low-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
40 Return to hospital as in- or outpatient because of bleeding (not pre-specified) 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
   40.1 High-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
   40.2 Low-income setting 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
41 Postnatal maternal mean Hb (outcome not pre-specified) 0 0 Mean Difference (IV, Random, 95% CI) 0.0 [0.0, 0.0]
   41.1 High-income setting 0 0 Mean Difference (IV, Random, 95% CI) 0.0 [0.0, 0.0]
   41.2 Low-income setting 0 0 Mean Difference (IV, Random, 95% CI) 0.0 [0.0, 0.0]