Summary of findings 1. X‐ray pelvimetry compared to no X‐ray pelvimetry in cephalic presentations for fetal cephalic presentations at or near term.
| X‐ray pelvimetry compared to no X‐ray pelvimetry in fetal cephalic presentations at or near term | ||||||
| Patient or population: pregnant women at or near term with fetal cephalic presentations Setting: hospital settings in Spain, United States, and South Africa. Intervention: X‐ray pelvimetry Comparison: no X‐ray pelvimetry in cephalic presentations | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Risk with no pelvimetry in cephalic presentations | Risk with X‐ray pelvimetry | |||||
| Caesarean section | Study population | RR 1.34 (1.19 to 1.52) | 1159 (5 RCTs) | ⊕⊕⊝⊝ LOW 1 | One study Crichton 1962 reported caesarean section and symphysiotomy together | |
| 388 per 1000 | 520 per 1000 (462 to 590) | |||||
| Perinatal mortality | Study population | RR 0.53 (0.19 to 1.45) | 1159 (5 RCTs) | ⊕⊝⊝⊝ VERY LOW 2 3 | ||
| 17 per 1000 | 9 per 1000 (3 to 25) | |||||
| Wound sepsis | Study population | RR 0.83 (0.26 to 2.67) | 288 (1 RCT) | ⊕⊝⊝⊝ VERY LOW 4 5 | ||
| 42 per 1000 | 35 per 1000 (11 to 111) | |||||
| Blood transfusion | Study population | RR 1.00 (0.39 to 2.59) | 288 (1 RCT) | ⊕⊝⊝⊝ VERY LOW 3 4 | ||
| 56 per 1000 | 56 per 1000 (22 to 144) | |||||
| Scar dehiscence | Study population | RR 0.59 (0.14 to 2.46) | 390 (2 RCTs) | ⊕⊝⊝⊝ VERY LOW 5 6 | ||
| 26 per 1000 | 15 per 1000 (4 to 63) | |||||
| Admission to special care baby units | Study population | RR 0.20 (0.01 to 4.13) | 288 (1 RCT) | ⊕⊝⊝⊝ VERY LOW 4 5 | ||
| 14 per 1000 | 3 per 1000 (0 to 57) | |||||
| Apgar score < 7 at 5 minutes | Study population | ‐ | (0 studies) | ‐ | No data reported for this outcome | |
| see comment | see comment | |||||
| *The risk in the intervention group (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: We are very confident that the true effect lies close to that of the estimate of the effect Moderate quality: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low quality: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect Very low quality: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect | ||||||
1 Most studies contributing data had design limitations. Two studies had serious design limitations (high risk of bias for sequence generation and allocation concealment) one of which contributed 37.4% of weight (‐2).
2 Most studies contributing data had design limitations. (‐1)
3 Wide confidence interval crossing the line of no effect, small sample size, few events and lack of precision. (‐2)
4 One study contributing data with serious design limitations. (‐2)
5 Very wide confidence intervals crossing the line of no effect, small sample size and few events. (‐2)
6 Study contributing 79.7% total weight has serious design limitations. (‐2)