Intervention and comparison intervention | Anticipated absolute effects* (95% CI) | Relative effect (95%CI) | Number of participants (studies) | Quality of the evidence (GRADE) | Comments | |
---|---|---|---|---|---|---|
Risk with comparison | Risk with intervention | |||||
Active management | ||||||
 McCormick 2002 [48] Active versus physiological management of third stage of labour | 30 per 1000 | 11 per 1000 (7–17) | RR 0.36 (0.23–0.57) | 4855 (3 studies) | Very low | Serious risk of bias, serious inconsistency, serious imprecision |
 Begley 2015 [21] Active versus expectant management of third stage of labour | 24 per 1000 | 8 per 1000 (3–21) | RR 0.34 (0.14–0.87) | 4636 (3 studies) | Very low | Serious risk of bias, serious inconsistency, serious imprecision |
 Du 2014 [47] Active management with CCT versus without CCT | 20 per 1000 | 19 per 1000 (16–22) | RR 0.91 (0.77–1.08) | 27,454 (3 studies) | Low | Serious risk of bias, serious inconsistency, serious imprecision |
Oxytocin | ||||||
 Westhoff 2013 [29] Prophylactic oxytocin versus placebo | 48 per 1000 | 30 per 1000 (21–42) | RR 0.62 (0.44–0.87) | 4162 (5 studies) | Moderate | Serious risk of bias |
 Soltani 2010 [27] Use of oxytocics before versus after delivery of placenta | 194 per 1000 | 191 per 1000 (93–385) | RR 0.98 (0.48–1.98) | 130 (1 study) | Low | Evidence based on a single study |
 Pantoja 2016 [51] Oxytocin injection in thigh versus no injection | 9 per 1000 | 1 per 1000 (0–12) | RR 0.16 (0.02–1.30) | 1569 (1 study) | Very low | Serious risk of bias, serious imprecision |
Prostaglandin | ||||||
 Joy 2003 [53] Oral misoprostol (400–600 mcg) versus placebo | 85 per 1000 | 79 per 1000 (56–109) | OR 0.34 (0.64–1.33) | 1505 (3 studies) | Low | Serious inconsistency, Serious imprecision |
 Joy 2003 [53] Rectal misoprostol (400 mcg) versus placebo | 70 per 1000 | 48 per 1000 (24–95) | OR 0.67 (0.33–1.39) | 542 (1 study) | Moderate | Evidence based on a single study |
 Langenbach 2006 [54] Oral or rectal misoprostol (400–600 mcg) versus placebo | 83 per 1000 | 70 per 1000 (52–94) | RR 0.85 (0.63–1.14) | 2112 (5 studies) | Very low | Serious risk of bias, serious inconsistency, serious imprecision |
 Hofmeyr 2009 [52] Oral or sublingual misoprostol (600 mcg) versus placebo | 48 per 1000 | 44 per 1000 (26–75) | RR 0.92 (0.54–1.57) | 4914 (5 studies) | Moderate | Serious inconsistency |
 Hofmeyr 2009 [52] Oral or rectal misoprostol (400 mcg) versus placebo | 51 per 1000 | 41 per 1000 (24–70) | RR 0.80 (0.47–1.37) | 3039 (5 studies) | Low | Serious inconsistency, serious imprecision |
 Tunçalp 2012 [32] Rectal misoprostol (400 mcg) versus placebo or no uterotonics | 70 per 1000 | 48 per 1000 (24–96) | RR 0.69 (0.35–1.37) | 542 (1 study) | Moderate | Evidence based on a single study |
 Tunçalp 2012 [32] Sublingual misoprostol (600 mcg) versus placebo or no uterotonics | 169 per 1000 | 112 per 1000 (76–166) | RR 0.69 (0.35–1.37) | 661 (1 study) | Moderate | Evidence based on a single study |
 Tunçalp 2012 [32] Buccal misoprostol (200 mcg) versus placebo or no uterotonics | 123 per 1000 | 139 per 1000 (81–238) | RR 1.13 (0.66–1.94) | 352 (1 study) | Moderate | Evidence based on a single study |
 Tunçalp 2012 [32] Prostaglandin versus placebo or no uterotonics | 125 per 1000 | 69 per 1000 (27–169) | RR 0.55 (0.22–1.35) | 46 (1 study) | Moderate | Evidence based on a single study |
Ergot alkaloids | ||||||
 Liabsuetrakul 2007 [33] Oral or intravenous ergot alkaloids versus no uterotonics | 31 per 1000 | 10 per 1000 (1–81) | RR 0.32 (0.04–2.59) | 1718 (2 studies) | Low | Serious inconsistency, serious imprecision |
Tranexamic acid | ||||||
 Faraoni 2014 [58] Tranexamic acids versus placebo or no treatment | 96 per 1000 | 47 per 1000 (32–71) | RR 0.49 (0.33–0.74) | 1754 (4 studies) | Moderate | Serious inconsistency |
 Novikova 2015 [59] Tranexamic acids versus placebo or no treatment | 37 per 1000 | 15 per 1000 (9–27) | RR 0.40 (0.23–0.71) | 2093 (6 studies) | Moderate | Serious inconsistency |
 Ker 2016 [60] Tranexamic acids versus placebo or no treatment | 30 per 1000 | 13 per 1000 (6–28) | RR 0.43 (0.20–0.94) | 1400 (2 studies) | Low | Serious risk of bias, serious imprecision |
Timing of cord clamping | ||||||
 McDonald, 2013 [22] Early versus late cord clamping | 34 per 1000 | 35 per 1000(22–56) | RR 1.04 (0.65–1.65) | 2066 (5 studies) | Moderate | Serious inconsistency |
Uterine massage | ||||||
 Hofmeyr 2013 [61] Uterine massage versus no massage | 2 per 1000 | 5 per 1000 (0–44) | RR 2.96 (0.31–28.35) | 1291 (2 studies) | Low | Serious inconsistency, serious imprecision |