Summary of findings 2. Crystalloid versus control.
| Crystalloid versus control for preventing hypotension during spinal anaesthesia for caesarean section | |||||
| Patient or population: women having spinal anaesthesia for caesarean section Setting: hospital settings in Europe, North America, India, and the Middle East Intervention: crystalloid Comparison: control | |||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Quality of the evidence (GRADE) | |
| Risk with control | Risk with crystalloid | ||||
| Maternal hypotension requiring intervention | Study population | RR 0.84 (0.72 to 0.98) | 370 (5 RCTs) | ⊕⊕⊝⊝ Lowa,b | |
| 535 per 1000 | 449 per 1000 (385 to 524) | ||||
| Maternal hypertension requiring intervention | No studies reported this outcome. | ||||
| Maternal bradycardia requiring intervention | No studies reported this outcome. | ||||
| Maternal nausea and/or vomiting | Study population | RR 0.19 (0.01 to 3.91) | 69 (1 RCT) |
⊕⊝⊝⊝ Very lowa,c |
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| 59 per 1000 | 11 per 1000 (1 to 230) |
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| Neonatal acidosis as defined by cord or neonatal blood with a pH < 7.2 | No studies reported this outcome. | ||||
| Neonatal Apgar score < 8 at 5 minutes | Study population | Not estimable | 60 (1 RCT) | ⊕⊕⊝⊝ Lowa,d | |
| 0 per 1000 | 0 per 1000 (0 to 0) | ||||
| Admission to neonatal intensive care unit | No studies reported this outcome. | ||||
| *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. | |||||
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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. | |||||
aOnly elective caesarean sections included (−1). bSmall sample size and CI includes potential for benefit or no benefit from the intervention (−1). cOne study with small sample size, few events, and wide confidence intervals that cross the line of no effect (−2). dNo events and small sample size (−1).