Prophylactic antibiotics for manual removal of retained placenta during vaginal birth: a systematic review of observational studies and meta-analysis

Table 3 GRADE tables (Non-randomized studies)

Quality assessment							No of patients		Effect		Quality	Importance
No. of studies	Design	Risk of bias	Inconsistency	Indirectness	Imprecision	Other considerations	Ab prophylaxis versus none	Control	Relative (95 % CI)	Absolute	Quality	Importance
Puerperal fever
1	observational studies	very serious^a	no serious inconsistency	no serious indirectness	serious^b	none	58/65 (89.2 %)	213/237 (89.9 %)	OR 0.93 (0.38 to 2.27)	7 fewer per 1000 (from 127 fewer to 54 more)	⊕ΟΟΟ VERY LOW	CRITICAL
1	observational studies	very serious^a	no serious inconsistency	no serious indirectness	serious^b	none		89.9 %	OR 0.93 (0.38 to 2.27)	7 fewer per 1000 (from 127 fewer to 54 more)	⊕ΟΟΟ VERY LOW	CRITICAL
Endometritis
3	observational studies	very serious^a	no serious inconsistency	no serious indirectness	serious^b	none	8/156 (5.1 %)	31/411 (7.5 %)	OR 0.84 (0.38 to 1.85)	11 fewer per 1000 (from 45 fewer to 56 more)	⊕ΟΟΟ VERY LOW	CRITICAL
3	observational studies	very serious^a	no serious inconsistency	no serious indirectness	serious^b	none		7.1 %	OR 0.84 (0.38 to 1.85)	11 fewer per 1000 (from 43 fewer to 53 more)	⊕ΟΟΟ VERY LOW	CRITICAL

Question: Antibiotic prophylaxis versus none for manual placental delivery during vaginal birth
Settings: Hospitals in Germany, Norway and Bulgaria
^aStudy contributing data had design limitations based on Newcastle Ottawa Scale rating, non-randomized data collection
^bWide confidence interval crossing the line of no effect

ISSN: 1471-2393