Table 3.
Interventions in labor. Calculations are CTG+ST analysis vs. CTG alone, presented as RR (95% confidence interval)
| Meta-analysis | Cochrane review Neilson (2012) | European MA Becker et al. (2012) | American MA Potti & Berghella (2012) | Stockholm MA Salmelin et al. (2013) | IPD MA Schuit et al. (2013) |
|---|---|---|---|---|---|
| Fetal scalp blood sampling | 486/4870 vs. 738/4801 (9.98 vs. 15.37%) Random-effect (Tau2 0.15, I2 92%, chi-square p < 0.00001): RR 0.61 (0.41–0.91) | Included 5 RCTs, detailed data not provided Random-effect (statistics not provided): RR 0.59 (0.44-0.79) Fixed-effect model: RR 0.60 (0.55–0.65) | MA not reported | 694/6478 vs. 1202/6426 (10.71 vs. 18.70%) Random-effect (Tau2 0.09, I2 92%, chi-square p < 0.00001): RR 0.55 (0.40–0.76) | 460/(6524–2565) vs. 941/(6463–2484) (11.61 vs. 23.65%) RR 0.49 (0.44–0.55) |
| Comments on fetal scalp blood sampling | Dutch RCT data (302/2827 vs. 578/2840) for unclear reasons not included in MA | Narrowing of the 95% CI with fixed-effect model | MA not reported because of heterogeneity >85% (I2 91%); detailed RCT data not presented | No errors found | Detailed IPD cannot be checked; for unknown reason Swedish RCT data were not available |
| Cesarean section, total | 876/7697 vs. 878/7641 (11.38 vs. 11.49%) Fixed-effect (I2 0%, chi-square p = 0.87): RR 0.99 (0.91–1.08) | Included 3 RCTs, detailed data not provided Random-effect (statistics not provided): RR 1.03 (0.87–1.2) | 876/7697 vs. 878/7641 (11.38 vs. 11.49%) Unknown MA type (statistics not provided): RR 0.99 (0.91–1.08) | MA not performed | RR 0.99 (0.91–1.09) |
| Comments on total cesarean section analysis | Total cesarean section rates not reported in Plymouth and French RCTs – data in MA provided by RCT authors | Unclear which 3 RCTs were included in MA, but data were not reported in Plymouth and French RCTs | Detailed RCT data not provided; total cesarean section rates were not reported in Plymouth and French RCTs; unclear how data were obtained | – | Detailed IPD cannot be checked; error in addition of cases: sum (n = 1534) doesn’t fit with additions of CSFD (n = 507) and CSFP (n = 763) |
| Cesarean section for fetal distress | MA not performed | Included 5 RCTs, detailed data not provided Random-effect (statistics not provided): RR 0.90 (0.67–1.2) | MA not performed | MA not performed | RR 0.99 (0.83–1.17) |
| Comments on cesarean section for fetal distress | – | Calculated from original RCT articles: 262/7697 vs. 277/7641 (3.40 vs. 3.63%) RR 0.94 (0.80–1.11) | – | – | Detailed IPD cannot be checked |
| Operative vaginal delivery, total | 660/4870 vs. 731/4801 (13.55 vs. 15.23%) Fixed-effect (I2 0.0%, chi-square p = 0.49): RR 0.89 (0.81–0.98) | Included 3 RCTs, detailed data not provided Fixed-effect (“among-study variance zero”): RR 0.88 (0.80–0.97) | 1044/7697 vs. 1162/7641 (13.56 vs. 15.19%) Fixed-effect (I2 0%, chi-square p = 0.66): RR 0.89 (0.83–0.97) | MA not performed | RR 0.90 (0.83–0.99) |
| Comments on operative vaginal delivery | For unclear reasons Dutch RCT data were not included in MA; Plymouth and French RCT data not in articles – data in MA provided by RCT authors | Random-effect model yielded same results; unclear which 3 RCTs were included in MA, but data not reported in Plymouth and French RCTs | Plymouth and French RCT data not in articles, unclear how these data were obtained | – | Detailed IPD cannot be checked; error in addition of cases: sum (n = 1732) doesn’t fit with additions of OVDFD (n = 821) and OVDFP (n = 652) |
| Operative vaginal delivery for fetal distress | MA not performed | Included 5 RCTs, detailed data not provided Fixed-effect (“among-study variance zero”): RR 0.86 (0.76–0.97) | MA not performed | MA not performed | RR 0.91 (0.80–1.05) |
| Comments on operative vaginal delivery for fetal distress | – | Random-effect model: RR 0.83 (0.67–1.0) | – | – | Detailed IPD cannot be checked |
| Total operative delivery for fetal distress | MA not performed | MA not performed | MA not performed | 639/6478 vs. 675/6426 (9.86 vs. 10.50%) Random-effect (Tau2 0.01, I2 52%, chi-square p = 0.10): RR 0.93 (0.80–1.08) | RR 0.94 (0.84–1.05) |
| Comments on total operative delivery for fetal distress | – | – | – | No errors found | Detailed IPD cannot be checked |
| Total operative delivery for failure to progress/other reasons | MA not performed | MA not performed | MA not performed | 937/6478 vs. 982/6426 (14.46 vs. 15.28%) Random-effect (Tau2 0.01, I2 44%, chi-square p = 0.15): RR 0.98 (0.86–1.12) | RR 0.95 (0.86–1.05) |
| Comments on total operative delivery for failure to progress/other reasons | – | – | – | No errors found | Detailed IPD cannot be checked; errors in addition of cases: sum (n = 1416) doesn’t fit with additions of CSFP (n = 763) and OVDFP (n = 652) |
| Total operative delivery | MA not performed | 1920/7697 vs. 2040/7641 (24.94 vs. 26.70%) Fixed-effect (“among-study variance zero”): RR 0.94 (0.89–0.99) | MA not performed | MA not performed | RR 0.94 (0.88–1.01) |
| Comments on total operative delivery | – | Random-effect model yielded same results | – | – | Detailed IPD cannot be checked |
CSFD, cesarean section for fetal distress; CSFP, cesarean section for failure to progress; OVDFD, operative vaginal delivery for fetal distress; OVDFP, operative vaginal delivery for failure to progress.