Summary of findings 2. One uterine devascularisation technique (uterine arterial embolisation) versus another uterine devascularisation technique (surgical devascularisation plus B‐Lynch).
| One uterine devascularisation technique (uterine arterial embolisation) versus another uterine devascularisation technique (surgical devascularisation plus B‐Lynch) | ||||||
| Patient or population: treating primary postpartum haemorrhage Setting: Ain‐Shams University Maternity Hospital, Egypt (Farouk 2016) Intervention: uterine devascularisation (uterine arterial embolisation) Comparison: another uterine devascularisation technique (surgical devascularisation plus B‐Lynch compression sutures) | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Risk with another uterine devascularisation technique (surgical devascularisation plus B‐Lynch compression suture) | Risk with uterine arterial embolisation | |||||
| Mortality due to bleeding ‐ not reported | See comment | Outcome not reported by trial authors | ||||
| Hysterectomy to control bleeding | Study population | RR 0.73 (0.15 to 3.57) | 23 (1 RCT) | ⊕⊝⊝⊝ VERY LOW 1 2 | ||
| 250 per 1000 | 183 per 1000 (38 to 893) | |||||
| Serious maternal morbidity (renal or respiratory failure, cardiac arrest or multiple organ failure) | See comment | Outcome not reported by trial authors | ||||
| Number of women with total blood loss 1000 mL or more after randomisation | See comment | Outcome not reported by trial authors | ||||
| Mean blood loss (mL) (trialist defined) | See comment | Outcome not reported by trial authors | ||||
| Blood transfusion (red cell or whole blood) | See comment | Outcome not reported by trial authors | ||||
| Side effects of the intervention (e.g. trauma, necrosis) | Study population | RR 1.09 (0.08 to 15.41) | 23 (1 RCT) | ⊕⊝⊝⊝ VERY LOW 1 2 | ||
| 83 per 1000 | 91 per 1000 (7 to 1000) | |||||
| *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 certainty: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: 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 certainty: our confidence in the effect estimate is limited; the true effect may be substantially different from the estimate of the effect. Very low certainty: we have very little confidence in the effect estimate; the true effect is likely to be substantially different from the estimate of effect. | ||||||
1 We downgraded (1) level for serious limitations in study design
2 We downgraded (2) levels for very serious imprecision due to small sample size with few events and wide confidence intervals crossing the line of no effect