Evidence map›Paper›PMID 34531222›Full record

SynthesisBMJ open2021

Route of oxytocin administration for preventing blood loss at caesarean section: a systematic review with meta-analysis.

Maria Regina Torloni, Monica Siaulys, Rachel Riera, Ana Luiza Cabrera Martimbianco, Rafael Leite Pacheco, Carolina de Oliveira Cruz Latorraca, Mariana Widmer, Ana Pilar Betran

Open access · goldAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
2.7field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.

  1. Side-effects of intravenouslyFrontiers in pharmacology · 2023
    Pooled it
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  4. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 7 institutions in 2 countries.

Maria Regina TorloniObstetrics Department, Hospital e Maternidade Santa Joana, Sao Paulo, Brazil ginecologia@terra.com.br.ORCID 0000-0003-4944-0720
Monica SiaulysAnaesthesiology Department, Hospital e Maternidade Santa Joana, Sao Paulo, Brazil.
Rachel RieraEvidence-Based Healthcare Post-Graduate Program, São Paulo Federal University-UNIFESP, Sao Paulo, Brazil.
Ana Luiza Cabrera MartimbiancoEvidence-Based Healthcare Post-Graduate Program, São Paulo Federal University-UNIFESP, Sao Paulo, Brazil.
Rafael Leite PachecoEvidence-Based Healthcare Post-Graduate Program, São Paulo Federal University-UNIFESP, Sao Paulo, Brazil.
Carolina de Oliveira Cruz LatorracaEvidence-Based Healthcare Post-Graduate Program, São Paulo Federal University-UNIFESP, Sao Paulo, Brazil.ORCID 0000-0001-9146-4684
Mariana WidmerReproductive Health and Research, UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland.
Ana Pilar BetranReproductive Health and Research, UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland.
World Health Organization · CHCentro Universitário São Camilo · BRHospital e Maternidade Celso Pierro · BRHospital Santa Paula · BRHospital Sírio-Libanês · BRUniversidade Federal de São Paulo · BRUniversidade Metropolitana de Santos · BR

Funding

World Health Organization 001
6 · The paper itself

Abstract

objectivesAssess the effects of different routes of prophylactic oxytocin administration for preventing blood loss at caesarean section (CS).

designSystematic review and meta-analysis.

methodsMedline, EMBASE, CINAHL, Cochrane Library, BVS, SciELO and Global Index Medicus were searched through 24 May 2020 for randomised controlled trials (RCTs) comparing different routes of prophylactic oxytocin administration during CS. Study selection, data extraction and quality assessment were conducted by two investigators independently. We pooled results in fixed effects meta-analyses and calculated average risk ratio (RR), mean difference (MD) and 95% CI. We used GRADE to assess the overall quality of evidence for each outcome.

resultsThree trials (180 women) were included in the review. All studies compared intramyometrial (IMY) versus intravenous oxytocin in women having prelabour CS. IMY compared with intravenous oxytocin administration may result in little or no difference in the incidence of postpartum haemorrhage (RR 0.14, 95% CI 0.01 to 2.70; N=100 participants; 1 RCT), hypotension (RR 1.00, 95% CI 0.29 to 3.45; N=40; 1 RCT), headache (RR 3.00, 95% CI 0.13 to 69.52; N=40; 1 RCT) or facial flushing (RR 0.50, 95% CI 0.05 to 5.08; N=40; 1 RCT); IMY oxytocin may reduce nausea/vomiting (RR 0.13, 95% CI 0.02 to 0.69; N=140; 2 RCTs). We are very uncertain about the effect IMY versus intravenous oxytocin on the need for additional uterotonics (RR 0.82; 95% CI 0.25 to 2.69; N=140; 2 RCTs). IMY oxytocin may reduce blood loss slightly (MD -57.40 mL, 95% CI -101.71 to -13.09; N=40; 1 RCT).

conclusionsThere is limited, low to very low certainty evidence on the effects of IMY versus intravenous oxytocin at CS for preventing blood loss. The evidence is insufficient to support choosing one route over another. More trials, including studies that assess intramuscular oxytocin administration, are needed on this relevant question. PROSPERO REGISTRATION NUMBER: CRD42020186797.

Indexed as

OxytocicsPostpartum HemorrhageCesarean SectionErgonovineFemaleHumansOxytocinPregnancyErgonovineOxytocicsOxytocinadult surgeryadverse eventsmaternal medicinetherapeutics

Identifiers

PMID34531222
PMCPMC8449971
OpenAlexW3199822052

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.