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postpartum haemorrhage" /></a></div><div class="bkr_bib"><h1 id="_NBK596278_"><span itemprop="name">Evidence reviews for pharmacological management of postpartum haemorrhage</span></h1><div class="subtitle">Intrapartum care</div><p><b>Evidence review O</b></p><p><i>NICE Guideline, No. 235</i></p><div class="half_rhythm">London: <a href="https://www.nice.org.uk" ref="pagearea=meta&targetsite=external&targetcat=link&targettype=publisher"><span itemprop="publisher">National Institute for Health and Care Excellence (NICE)</span></a>; <span itemprop="datePublished">2023 Sep</span>.<div class="small">ISBN-13: <span itemprop="isbn">978-1-4731-5400-1</span></div></div><div><a href="/books/about/copyright/">Copyright</a> © NICE 2023.</div></div><div class="bkr_clear"></div></div><div id="niceng235er15.s1"><h2 id="_niceng235er15_s1_">Pharmacological management of postpartum haemorrhage</h2><div id="niceng235er15.s1.1"><h3>Review question</h3><p>What is the effectiveness of pharmacological treatments for the management of postpartum haemorrhage?</p><div id="niceng235er15.s1.1.1"><h4>Introduction</h4><p>Postpartum haemorrhage (PPH), defined as the loss of ≥500 mL of blood from the genital tract in the 24 hours following the birth of a baby, is one of the leading causes of maternal death globally and can also have a significant psychological impact on women. PPH can lead to the need for blood and blood product transfusion, further interventions, and even the need for hysterectomy.</p><p>Identifying the most effective pharmacological interventions or treatments that minimise blood loss, reduce mortality and improve women’s experience of birth is therefore important, but there is uncertainty about the most effective pharmacological treatments and dosage regimens for women who develop PPH. The most effective sequencing of pharmacological interventions is also uncertain.</p><p>This review aims to identify the most effective pharmacological interventions (including doses) to manage primary PPH.</p></div><div id="niceng235er15.s1.1.2"><h4>Summary of the protocol</h4><p>See <a class="figpopup" href="/books/NBK596278/table/niceng235er15.tab1/?report=objectonly" target="object" rid-figpopup="figniceng235er15tab1" rid-ob="figobniceng235er15tab1">Table 1</a> for a summary of the Population, Intervention, Comparison and Outcome (PICO) characteristics of this review.</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng235er15tab1"><a href="/books/NBK596278/table/niceng235er15.tab1/?report=objectonly" target="object" title="Table 1" class="img_link icnblk_img figpopup" rid-figpopup="figniceng235er15tab1" rid-ob="figobniceng235er15tab1"><img class="small-thumb" src="/books/NBK596278/table/niceng235er15.tab1/?report=thumb" src-large="/books/NBK596278/table/niceng235er15.tab1/?report=previmg" alt="Table 1. Summary of the protocol (PICO table)." /></a><div class="icnblk_cntnt"><h4 id="niceng235er15.tab1"><a href="/books/NBK596278/table/niceng235er15.tab1/?report=objectonly" target="object" rid-ob="figobniceng235er15tab1">Table 1</a></h4><p class="float-caption no_bottom_margin">Summary of the protocol (PICO table). </p></div></div><p>For further details see the review protocol in <a href="#niceng235er15.appa">appendix A</a>.</p></div><div id="niceng235er15.s1.1.3"><h4>Methods and process</h4><p>This evidence review was developed using the methods and process described in <a href="https://www.nice.org.uk/process/pmg20/chapter/introduction" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a>. Methods specific to this review question are described in the review protocol in <a href="#niceng235er15.appa">appendix A</a> and the <a href="/books/NBK596278/bin/NG235_Supplement_1_Methods.pdf">methods</a> document (supplementary document 1).</p><p>During guideline development, the BNF notation for oxytocin dose changed to ‘units’, so this has been reflected in the evidence report. The evidence tables in <a href="#niceng235er15.appd">appendix D</a> reflect the dose notations as defined by the original study.</p><p>Declarations of interest were recorded according to <a href="https://www.nice.org.uk/about/who-we-are/policies-and-procedures" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NICE’s conflicts of interest policy</a>.</p></div><div id="niceng235er15.s1.1.4"><h4>Effectiveness evidence</h4><div id="niceng235er15.s1.1.4.1"><h5>Included studies</h5><p>Eleven publications were included for this review: 2 publications were Cochrane systematic reviews (<a class="bibr" href="#niceng235er15.s1.ref12" rid="niceng235er15.s1.ref12">Mousa 2014</a> and <a class="bibr" href="#niceng235er15.s1.ref15" rid="niceng235er15.s1.ref15">Shakur 2018</a>) that included 10 randomised controlled trials (RCTs) (from <a class="bibr" href="#niceng235er15.s1.ref12" rid="niceng235er15.s1.ref12">Mousa 2014</a>: <a class="bibr" href="#niceng235er15.s1.ref3" rid="niceng235er15.s1.ref3">Blum 2010</a>, <a class="bibr" href="#niceng235er15.s1.ref7" rid="niceng235er15.s1.ref7">Hofmeyr 2004</a>, <a class="bibr" href="#niceng235er15.s1.ref10" rid="niceng235er15.s1.ref10">Lokugamage 2001</a>, <a class="bibr" href="#niceng235er15.s1.ref16" rid="niceng235er15.s1.ref16">Walraven 2004</a>, <a class="bibr" href="#niceng235er15.s1.ref18" rid="niceng235er15.s1.ref18">Widmer 2010</a>, <a class="bibr" href="#niceng235er15.s1.ref19" rid="niceng235er15.s1.ref19">Winikoff 2010</a>, <a class="bibr" href="#niceng235er15.s1.ref21" rid="niceng235er15.s1.ref21">Zuberi 2008</a>; from <a class="bibr" href="#niceng235er15.s1.ref15" rid="niceng235er15.s1.ref15">Shakur 2018</a>: <a class="bibr" href="#niceng235er15.s1.ref6" rid="niceng235er15.s1.ref6">Ducloy-Bouthers 2011</a>, <a class="bibr" href="#niceng235er15.s1.ref13" rid="niceng235er15.s1.ref13">Sahhaf 2014</a>, <a class="bibr" href="#niceng235er15.s1.ref14" rid="niceng235er15.s1.ref14">Shakur 2017</a>), and 9 publications were separate RCTs (<a class="bibr" href="#niceng235er15.s1.ref1" rid="niceng235er15.s1.ref1">Abbas 2019</a>, <a class="bibr" href="#niceng235er15.s1.ref2" rid="niceng235er15.s1.ref2">Abbas 2020</a>, <a class="bibr" href="#niceng235er15.s1.ref4" rid="niceng235er15.s1.ref4">Dallaku 2019</a>, <a class="bibr" href="#niceng235er15.s1.ref5" rid="niceng235er15.s1.ref5">Diop 2020</a>, Javadi 2012, <a class="bibr" href="#niceng235er15.s1.ref9" rid="niceng235er15.s1.ref9">Kumari 2022</a>, <a class="bibr" href="#niceng235er15.s1.ref11" rid="niceng235er15.s1.ref11">Maged 2016</a>, <a class="bibr" href="#niceng235er15.s1.ref17" rid="niceng235er15.s1.ref17">Wang 2020</a>, <a class="bibr" href="#niceng235er15.s1.ref20" rid="niceng235er15.s1.ref20">Zeng 2022</a>). One RCT (<a class="bibr" href="#niceng235er15.s1.ref4" rid="niceng235er15.s1.ref4">Dallaku 2019</a>) was a sub-study of a larger RCT (<a class="bibr" href="#niceng235er15.s1.ref14" rid="niceng235er15.s1.ref14">Shakur 2017</a>).</p><p>Six RCTs compared misoprostol to placebo (<a class="bibr" href="#niceng235er15.s1.ref1" rid="niceng235er15.s1.ref1">Abbas 2019</a>, <a class="bibr" href="#niceng235er15.s1.ref2" rid="niceng235er15.s1.ref2">Abbas 2020</a>, <a class="bibr" href="#niceng235er15.s1.ref7" rid="niceng235er15.s1.ref7">Hofmeyr 2004</a>, <a class="bibr" href="#niceng235er15.s1.ref16" rid="niceng235er15.s1.ref16">Walraven 2004</a>, <a class="bibr" href="#niceng235er15.s1.ref18" rid="niceng235er15.s1.ref18">Widmer 2010</a>, and <a class="bibr" href="#niceng235er15.s1.ref21" rid="niceng235er15.s1.ref21">Zuberi 2008</a>). Two RCTs compared misoprostol to intravenous (IV) oxytocin (<a class="bibr" href="#niceng235er15.s1.ref3" rid="niceng235er15.s1.ref3">Blum 2010</a> and <a class="bibr" href="#niceng235er15.s1.ref19" rid="niceng235er15.s1.ref19">Winikoff 2010</a>). Two RCTs compared tranexamic acid (TXA) to placebo (<a class="bibr" href="#niceng235er15.s1.ref6" rid="niceng235er15.s1.ref6">Ducloy-Bouthors 2011</a> and <a class="bibr" href="#niceng235er15.s1.ref14" rid="niceng235er15.s1.ref14">Shakur 2017</a>). One RCT compared TXA plus misoprostol to placebo plus misoprostol (<a class="bibr" href="#niceng235er15.s1.ref5" rid="niceng235er15.s1.ref5">Diop 2020</a>). One RCT compared TXA plus oxytocin infusion plus ergometrine to oxytocin infusion plus ergometrine (<a class="bibr" href="#niceng235er15.s1.ref8" rid="niceng235er15.s1.ref8">Javadi 2015</a>). One RCT compared misoprostol to syntometrine (intramuscular (IM) oxytocin and ergometrine) plus IV oxytocin (<a class="bibr" href="#niceng235er15.s1.ref10" rid="niceng235er15.s1.ref10">Lokugamage 2001</a>). One RCT compared carbetocin to IV oxytocin (<a class="bibr" href="#niceng235er15.s1.ref11" rid="niceng235er15.s1.ref11">Maged 2016</a>). Two RCTs compared TXA to misoprostol (<a class="bibr" href="#niceng235er15.s1.ref9" rid="niceng235er15.s1.ref9">Kumari 2022</a>, <a class="bibr" href="#niceng235er15.s1.ref13" rid="niceng235er15.s1.ref13">Sahhaf 2014</a>). One RCT compared carboprost plus oxytocin to oxytocin alone (<a class="bibr" href="#niceng235er15.s1.ref17" rid="niceng235er15.s1.ref17">Wang 2020</a>). One RCT compared carbetocin to TXA.</p><p>The studies were from Afghanistan, Albania, Argentina, Bangladesh, Burkina Faso, Cameroon, China, Colombia, Cote d’Ivoire, Democratic Republic of Congo, Ecuador, Egypt, Ethiopia, France, Gambia, Ghana, India, Iran, Jamaica, Kenya, Nepal, Nigeria, Pakistan, Papua New Guinea, Senegal, South Africa, Sudan, Tanzania, Thailand, Turkey, United Kingdom, Uganda, Vietnam and Zambia.</p><p>The included studies are summarised in <a class="figpopup" href="/books/NBK596278/table/niceng235er15.tab2/?report=objectonly" target="object" rid-figpopup="figniceng235er15tab2" rid-ob="figobniceng235er15tab2">Table 2</a>.</p><p>See the literature search strategy in <a href="#niceng235er15.appb">appendix B</a> and study selection flow chart in <a href="#niceng235er15.appc">appendix C</a>.</p></div><div id="niceng235er15.s1.1.4.2"><h5>Excluded studies</h5><p>Studies not included in this review are listed, and reasons for their exclusion are provided in <a href="#niceng235er15.appj">appendix J</a>.</p></div></div><div id="niceng235er15.s1.1.5"><h4>Summary of included studies</h4><p>Summaries of the studies that were included in this review are presented in <a class="figpopup" href="/books/NBK596278/table/niceng235er15.tab2/?report=objectonly" target="object" rid-figpopup="figniceng235er15tab2" rid-ob="figobniceng235er15tab2">Table 2</a>.</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng235er15tab2"><a href="/books/NBK596278/table/niceng235er15.tab2/?report=objectonly" target="object" title="Table 2" class="img_link icnblk_img figpopup" rid-figpopup="figniceng235er15tab2" rid-ob="figobniceng235er15tab2"><img class="small-thumb" src="/books/NBK596278/table/niceng235er15.tab2/?report=thumb" src-large="/books/NBK596278/table/niceng235er15.tab2/?report=previmg" alt="Table 2. Summary of included studies." /></a><div class="icnblk_cntnt"><h4 id="niceng235er15.tab2"><a href="/books/NBK596278/table/niceng235er15.tab2/?report=objectonly" target="object" rid-ob="figobniceng235er15tab2">Table 2</a></h4><p class="float-caption no_bottom_margin">Summary of included studies. </p></div></div><p>See the full evidence tables in <a href="#niceng235er15.appd">appendix D</a> and the forest plots in <a href="#niceng235er15.appe">appendix E</a>.</p></div><div id="niceng235er15.s1.1.6"><h4>Summary of the evidence</h4><div id="niceng235er15.s1.1.6.1"><h5>All comparisons – maternal death</h5><p>Across the comparisons identified in this review that reported maternal death, there was no important difference between the interventions (misoprostol versus placebo, misoprostol versus oxytocin, TXA versus placebo, TXA plus misoprostol versus placebo plus misoprostol, and carbetocin versus oxytocin). However, there was an exception between TXA versus placebo when maternal deaths due to bleeding were analysed separately. In this case, TXA had an important benefit with fewer maternal deaths due to bleeding. Most of the evidence reporting maternal death was rated as high quality, with exceptions for TXA plus misoprostol versus placebo plus misoprostol, and carbetocin versus oxytocin, where the evidence was rated as low to moderate, with concerns around imprecision.</p></div><div id="niceng235er15.s1.1.6.2"><h5>Misoprostol versus placebo</h5><p>For the comparison of misoprostol versus placebo, there was no important difference for blood loss volume, need for additional pharmacological management or need for additional surgical management. Most of the evidence was rated high quality, with the exception of some outcomes rated very low to low due to concerns around imprecision, and some concerns for inconsistency and indirectness. All the evidence was from low/middle income countries.</p></div><div id="niceng235er15.s1.1.6.3"><h5>Misoprostol versus oxytocin</h5><p>When misoprostol was compared to oxytocin, high quality evidence showed that misoprostol had an important harm when compared to oxytocin in terms of need for additional pharmacological management, in all women and in women who did not receive oxytocin prophylaxis. However, in women who had received oxytocin prophylaxis there was no evidence of an important difference, with the quality of the evidence rated as low due to concerns over imprecision. There was no important difference or no evidence of an important difference for blood loss volume, or need for additional surgical management. The evidence was rated low to high quality with some concerns around imprecision. All the evidence was in low income countries.</p></div><div id="niceng235er15.s1.1.6.4"><h5>TXA versus placebo</h5><p>TXA was compared to placebo in studies conducted in low/middle and high income countries. One study was a multicentre study which provided data on low, middle and high income countries. The data from this study could not be stratified by low/middle versus high, and so has been analysed as mixed income. However, it was analysed separately from the study reporting in high income countries only. There was no evidence of an important difference, or no important differences for outcomes blood loss volume, occlusive/embolic events, coagulation, need for additional pharmacological management, or need for additional surgical management.</p><p>The quality of the evidence ranged from low to high. Apart from risk of bias due to reporting subjective outcomes for blood volume loss, all other concerns around quality were due to imprecision.</p></div><div id="niceng235er15.s1.1.6.5"><h5>TXA plus misoprostol versus placebo plus misoprostol</h5><p>TXA plus misoprostol was compared to placebo plus misoprostol in low/middle income countries. There was no important difference or no evidence of an important difference, between interventions for blood loss volume, need for additional pharmacological or surgical management. The evidence was mainly of moderate quality with concerns over imprecision.</p></div><div id="niceng235er15.s1.1.6.6"><h5>TXA plus oxytocin plus ergometrine versus oxytocin plus ergometrine</h5><p>When TXA plus oxytocin plus ergometrine was compared to oxytocin plus ergometrine, there was an important benefit favouring TXA plus oxytocin plus ergometrine in terms of the number of women with blood loss volume between 500 to 1000ml and 1000 to 2000ml, but no evidence of difference in the number of women with blood loss volume over 2000ml. The evidence was rated as very low to moderate. Very low quality evidence showed no important differences in terms of thromboembolism, and low quality evidence showed a possible important benefit favouring TXA plus oxytocin plus ergometrine in terms of need for additional surgical management. Most of the quality concerns were around risk of bias and some concerns around imprecision. The evidence was from a low/middle income country.</p></div><div id="niceng235er15.s1.1.6.7"><h5>Misoprostol versus syntometrine plus oxytocin</h5><p>Misoprostol was compared to syntometrine (IM oxytocin and ergometrine) plus IV oxytocin in a low/middle income country. Very low to low quality evidence showed an important benefit for misoprostol in terms of need for additional pharmacological and surgical management. There were concerns around the risk of bias and imprecision. The evidence did not report whether the women had received uterotonic prophylaxis.</p></div><div id="niceng235er15.s1.1.6.8"><h5>Carbetocin versus oxytocin</h5><p>Carbetocin was compared to oxytocin in a low/middle income country. There was no important difference between blood loss volume. However, there was an important benefit favouring carbetocin for need for additional pharmacological and surgical management. The quality of the evidence ranged from moderate to low and was downgraded due to concerns over imprecision.</p></div><div id="niceng235er15.s1.1.6.9"><h5>TXA versus misoprostol</h5><p>For the comparison of TXA versus misoprostol, there was data on blood loss volume which showed no important difference. The evidence came from a low/middle income countries and was rated low quality due to risk of bias concerns.</p></div><div id="niceng235er15.s1.1.6.10"><h5>Carboprost plus oxytocin versus oxytocin alone</h5><p>For the comparison carboprost plus oxytocin versus oxytocin alone, there was an important benefit favouring carboprost on blood loss volume at 2, 6 and 12 hours after birth but an important harm for blood loss volume at 24 hours after birth. All the evidence was of low quality due to concerns around risk of bias and indirectness of the data, as diagnosis of postpartum haemorrhage was unclear. The evidence came from low/middle income country.</p></div><div id="niceng235er15.s1.1.6.11"><h5>Carbetocin versus TXA</h5><p>For the comparison of carbetocin versus TXA, there was data on blood loss volume which showed an important benefit of carbetocin. The evidence came from a low/middle income country and was rated low to very low due to risk of bias and imprecision.</p><p>There was no evidence identified for the outcomes breastfeeding or women’s and partner’s experience and satisfaction of labour and birth and postnatal period.</p><p>See <a href="#niceng235er15.appf">appendix F</a> for full GRADE tables.</p></div></div><div id="niceng235er15.s1.1.7"><h4>Economic evidence</h4><div id="niceng235er15.s1.1.7.1"><h5>Included studies</h5><p>Two economic studies were identified which were relevant to this question (<a class="bibr" href="#niceng235er15.s1.ref22" rid="niceng235er15.s1.ref22">Sudhof 2019</a>, <a class="bibr" href="#niceng235er15.s1.ref23" rid="niceng235er15.s1.ref23">Howard 2022</a>).</p><p>See the literature search strategy in <a href="#niceng235er15.appb">appendix B</a> and economic study selection flow chart in <a href="#niceng235er15.appg">appendix G</a>.</p></div><div id="niceng235er15.s1.1.7.2"><h5>Excluded studies</h5><p>Economic studies not included in this review are listed, and reasons for their exclusion are provided in <a href="#niceng235er15.appj">appendix J</a>.</p></div></div><div id="niceng235er15.s1.1.8"><h4>Summary of included economic evidence</h4><p>See <a class="figpopup" href="/books/NBK596278/table/niceng235er15.tab3/?report=objectonly" target="object" rid-figpopup="figniceng235er15tab3" rid-ob="figobniceng235er15tab3">Table 3</a> for the economic evidence profile of the included study.</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng235er15tab3"><a href="/books/NBK596278/table/niceng235er15.tab3/?report=objectonly" target="object" title="Table 3" class="img_link icnblk_img figpopup" rid-figpopup="figniceng235er15tab3" rid-ob="figobniceng235er15tab3"><img class="small-thumb" src="/books/NBK596278/table/niceng235er15.tab3/?report=thumb" src-large="/books/NBK596278/table/niceng235er15.tab3/?report=previmg" alt="Table 3. Economic evidence profile of a systematic review of economic evaluations of pharmacological treatments for the management of postpartum haemorrhage." /></a><div class="icnblk_cntnt"><h4 id="niceng235er15.tab3"><a href="/books/NBK596278/table/niceng235er15.tab3/?report=objectonly" target="object" rid-ob="figobniceng235er15tab3">Table 3</a></h4><p class="float-caption no_bottom_margin">Economic evidence profile of a systematic review of economic evaluations of pharmacological treatments for the management of postpartum haemorrhage. </p></div></div></div><div id="niceng235er15.s1.1.9"><h4>Economic model</h4><p>No economic modelling was undertaken for this review because the committee agreed that other topics were higher priorities for economic evaluation.</p></div><div id="niceng235er15.s1.1.10"><h4>Unit costs</h4><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng235er15tab4"><a href="/books/NBK596278/table/niceng235er15.tab4/?report=objectonly" target="object" title="Table" class="img_link icnblk_img figpopup" rid-figpopup="figniceng235er15tab4" rid-ob="figobniceng235er15tab4"><img class="small-thumb" src="/books/NBK596278/table/niceng235er15.tab4/?report=thumb" src-large="/books/NBK596278/table/niceng235er15.tab4/?report=previmg" alt="Image " /></a><div class="icnblk_cntnt"><h4 id="niceng235er15.tab4"><a href="/books/NBK596278/table/niceng235er15.tab4/?report=objectonly" target="object" rid-ob="figobniceng235er15tab4">Table</a></h4></div></div></div><div id="niceng235er15.s1.1.11"><h4>The committee’s discussion and interpretation of the evidence</h4><div id="niceng235er15.s1.1.11.1"><h5>The outcomes that matter most</h5><p>Maternal death, blood loss volume and coagulation//coagulopathy/occlusive events/embolic events were prioritised as critical outcomes by the committee. Maternal death was prioritised as a critical outcome as postpartum haemorrhage can lead to maternal death if it is not controlled. Blood loss volume was also prioritised as this would be an indicator of the effectiveness of pharmacological treatments to reduce blood loss and consequently maternal deaths. Coagulation/coagulopathy and occlusive/embolic events were also prioritised as critical, as this could be a serious side effect of using pharmacological treatments for postpartum haemorrhage.</p><p>The committee agreed that as well as the critical outcomes, the need for additional pharmacological management of haemorrhage, and the need for additional surgical management of haemorrhage should be important outcomes. This would also give an indication of the effectiveness of the interventions as it would show whether they were effective enough to stop bleeding, or if further interventions had to be used. The committee also agreed that breastfeeding was an important outcome as women with high amounts of blood loss may find breastfeeding difficult. Women’s and partner’s experience and satisfaction of labour and birth and postnatal period was also chosen as an important outcome because postpartum haemorrhage can be a traumatic event for both the woman and her partner and the committee wanted to find out whether any of the interventions have an impact on satisfaction.</p></div><div id="niceng235er15.s1.1.11.2"><h5>The quality of the evidence</h5><p>The quality of the evidence for outcomes was assessed with GRADE and was rated as high to very low. The main reason why outcomes were downgraded was imprecision around the effect estimate. The risk of bias assessment indicated in some outcomes concerns over randomisation, blinding or participants and outcome assessors, subjective reporting of some outcomes, and lack of information on missing outcome data. There were also some concerns around inconsistency for some outcomes where subgroup analysis could not be performed. Some outcomes were downgraded due to unclear criteria for diagnosis of postpartum haemorrhage.</p><p>There was no evidence identified for the outcomes of breastfeeding or women’s and partner’s experience and satisfaction of labour and birth and postnatal period.</p></div><div id="niceng235er15.s1.1.11.3"><h5>Benefits and harms</h5><p>The committee discussed that PPH is a medical emergency which requires a coordinated team response and that pharmacological treatments form only a part of this response. Furthermore, a number of pharmacological treatments are often used in succession or in combination. The committee were aware that the 2014 version of the Intrapartum care guideline advised the use of oxytocin and ergometrine as first-line treatments, repeat doses of oxytocin, misoprostol or carboprost as second-line treatments, and tranexamic acid or clotting factors as adjuvant options. The committee discussed the fact that the choice of pharmacological treatments used to treat postpartum haemorrhage depended on the uterotonics that had been given previously for active management of the third stage of labour. For example, ergometrine cannot be repeated so if women had received ergometrine as part of active management of the third stage they could not receive it again for the management of postpartum haemorrhage. The committee agreed this had not been clear in the previous guideline and so reformulated the recommendations into a table which made this easier to describe.</p><p>The committee were aware that the NICE surveillance decision to review the evidence for the management of PPH was based primarily on the fact that new evidence was available for the benefits of tranexamic acid and so the committee reviewed all the evidence identified, but focused particularly on the role of tranexamic acid in the overall treatment pathway. However, the committee noted that the evidence presented did not provide any information regarding the ideal sequencing of pharmacological treatments for the management of PPH.</p><p>There was no evidence for the use of oxytocin compared to placebo or ergometrine compared to placebo, but the committee were aware from their own knowledge and experience that these agents were effective in practice and there was nothing in the evidence that suggested any harms and so they agreed not to change the recommendations to use these medicines for the treatment of PPH, depending on whether or not they had been used as part of active management. The committee were aware that the half-life of oxytocin was very short and that for the management of PPH it was preferable to set up an intravenous infusion of oxytocin to provide a more sustained effect.</p><p>The committee discussed the evidence for tranexamic acid, and agreed that there was a clear benefit compared to placebo in terms of maternal death due to bleeding. The committee discussed that, although the current recommendations advised tranexamic acid as adjuvant treatment after uterotonics have been tried first, due to the different mechanisms of actions, it would be logical if uterotonics and tranexamic acid could be given in combination. This use of combination therapy was reinforced by the evidence from the combination of tranexamic acid with oxytocin and ergometrine that showed benefits on blood loss volume and possible benefits on the need for additional surgical intervention, compared to oxytocin and ergometrine alone. The committee discussed the dose of tranexamic acid and noted that the recommended dose in the Summary of Product Characteristics is 1g given intravenously over 10 minutes. This can then be followed by an intravenous infusion. However, the committee discussed that in the case of ongoing postpartum haemorrhage it was more common practice to give a repeat injection after 30 minutes and that this was reflected in the international <a href="https://obgyn.onlinelibrary.wiley.com/doi/10.1002/ijgo.14116" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">FIGO guidelines</a> and the <a href="https://phw.nhs.wales/services-and-teams/improvement-cymru/our-work/maternity-cymru/obs-cymru/obstetric-bleeding-strategy-cymru/all-wales-postpartum-haemorrhage-guidelines/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Welsh PPH guidelines</a>.</p><p>The committee discussed the evidence for misoprostol and noted that although on its own it did not show any benefits compared to placebo, it showed equivalent efficacy to oxytocin alone and there was some evidence from a single study that when used in combination with oxytocin and ergometrine, it reduced the need for additional pharmacological and surgical treatment. The committee therefore agreed that misoprostol should remain one of the treatment options for PPH. The committee noted that misoprostol was given orally or rectally and therefore may be of particular benefit in home births, midwife-led settings or before intravenous access could be established to give other uterotonics.</p><p>The committee discussed the evidence which showed a benefit of carbetocin over oxytocin in terms of the need for additional pharmacological and surgical management and carbetocin over tranexamic acid, with a reduced blood loss seen with carbetocin. The committee noted that carbetocin was now recommended for active management of the third stage of labour in women having a caesarean birth (see Evidence review M). They highlighted that carbetocin could not be repeated, but agreed that it could be used as an option when additional uterotonics were needed in women who had not previously received carbetocin.</p><p>The committee finally discussed the evidence for carboprost. This had shown benefit in combination with oxytocin at reducing blood loss at 2, 6 and 12 hours, compared to oxytocin alone, but the committee noted that by 24 hours the oxytocin alone arm was more effective at reducing blood loss. The committee also discussed the low quality of the evidence, however they were aware from their own experience that carboprost is not associated with any harm, that in the majority of cases the bleeding would have resolved by 12 hours and that as carboprost was still a useful second-line treatment in addition to oxytocin for up to 12 hours after birth, they agreed to retain it as part of the recommendations.</p><p>The committee discussed that some of the evidence was in women who had received oxytocin prophylaxis (that is, an injection of oxytocin as part of the active management of the third stage of labour) and some was for women who had not received this. In the UK, the majority of women still receive active management of the third stage, although physiological management (where no oxytocin is administered) may be more common in women who give birth at home or in a midwife-led unit. In the studies where sub-group analysis was possible, there was no difference between the outcomes for women whether or not they had had oxytocin prophylaxis, except for one outcome in the comparison of misoprostol versus oxytocin: women receiving oxytocin had less need for additional pharmacological management than women receiving misoprostol when analysed in all women and in women who had no oxytocin prophylaxis, but no benefit was seen in women who had received oxytocin prophylaxis. This reinforced the committee’s view that the choice of agents to treat PPH should take into consideration the medication that has already been administered during the active third stage, and that giving women who had already received one dose of oxytocin another dose of oxytocin was unlikely to be the most effective strategy.</p></div><div id="niceng235er15.s1.1.11.4"><h5>Cost effectiveness and resource use</h5><p>The committee noted that the acquisition costs of all the medicines being recommended for the management of PPH were low and were likely to be far outweighed by the cost of a PPH, which if not treated promptly could lead to serious maternal consequences including ITU admission.</p><p>The evidence review identified 2 economic studies (<a class="bibr" href="#niceng235er15.s1.ref22" rid="niceng235er15.s1.ref22">Sudhof 2019</a>, <a class="bibr" href="#niceng235er15.s1.ref23" rid="niceng235er15.s1.ref23">Howard 2022</a>) in a United States setting which compared tranexamic acid to no tranexamic acid for women with postpartum haemorrhage. Whilst both studies found tranexamic acid to be cost-effective it was not possible for the committee to make recommendations for tranexamic acid as a first line treatment because its cost-effectiveness was not assessed against other uterotonics. Nevertheless, the committee believed it provided some cost-effectiveness justification to their recommendation to give tranexamic acid in combination with other uterotonic drugs to manage postpartum haemorrhage.</p></div><div id="niceng235er15.s1.1.11.5"><h5>Other factors the committee took into account</h5><p>The committee were disappointed that there was no evidence on breastfeeding or maternal experience or satisfaction and so made a research recommendation.</p><p>However, the committee did consider the use of the recommended drugs and the potential risk to babies who were breastfed after their mothers had received treatment for PPH. There are not considered any contraindications to breastfeeding for women who have received tranexamic acid, oxytocin, carbetocin or misoprostol, although additional monitoring of the baby may be considered.</p><p>Ergometrine may interfere with lactation although this is unlikely after short-term administration. Carboprost may be present in breast milk but is likely to be degraded in the baby’s gastrointestinal tract, and so will not lead to systemic effects in the baby.</p></div></div><div id="niceng235er15.s1.1.12"><h4>Recommendations supported by this evidence review</h4><p>This evidence review supports recommendations 1.10.34and 1.10.35 and a research recommendation. Other evidence supporting these recommendations can be found in the evidence review M on Uterotonics for the prevention of postpartum haemorrhage.</p></div></div><div id="niceng235er15.s1.rl.r1"><h3>References – included studies</h3><ul class="simple-list"><div id="niceng235er15.s1.rl.r1.1"><h4>Effectiveness</h4><ul class="simple-list"><li class="half_rhythm"><p><div class="bk_ref" id="niceng235er15.s1.ref1"><p id="p-218">
|
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<strong>Abbas 2019</strong>
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|
</p>Abbas, Dina F., Diop, Ayisha, Durocher, Jill
|
|
et al. (2019) Using misoprostol to treat postpartum hemorrhage in home deliveries attended by traditional birth attendants. International Journal of Gynecology and Obstetrics
|
|
144(3): 290–296 [<a href="https://pubmed.ncbi.nlm.nih.gov/30582753" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30582753</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng235er15.s1.ref2"><p id="p-219">
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<strong>Abbas 2020</strong>
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</p>Abbas, Dina F., Durocher, Jill, Byrne, Meagan E.
|
|
et al. (2020) Testing a home-based model of care using misoprostol for prevention and treatment of postpartum hemorrhage: Results from a randomized placebo-controlled trial conducted in Badakhshan province, Afghanistan. Reproductive Health
|
|
17(1): 88 [<a href="/pmc/articles/PMC7275481/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7275481</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/32503556" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32503556</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng235er15.s1.ref3"><p id="p-220">
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<strong>Blum 2010</strong>
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</p>Blum, Jennifer, Winikoff, Beverly, Raghavan, Sheila
|
|
et al. (2010) Treatment of post-partum haemorrhage with sublingual misoprostol versus oxytocin in women receiving prophylactic oxytocin: a double-blind, randomised, non-inferiority trial. The Lancet
|
|
375(9710): 217–223 [<a href="https://pubmed.ncbi.nlm.nih.gov/20060162" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20060162</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng235er15.s1.ref4"><p id="p-221">
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|
<strong>Dallaku 2019</strong>
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</p>Dallaku, Kastriot, Shakur-Still, Haleema, Beaumont, Danielle
|
|
et al. (2019) No effect of tranexamic acid on platelet function and thrombin generation (ETAPlaT) in postpartum haemorrhage: a randomised placebo-controlled trial. Wellcome open research
|
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4: 21 [<a href="/pmc/articles/PMC6556984/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6556984</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/31223662" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31223662</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng235er15.s1.ref5"><p id="p-222">
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|
<strong>Diop 2020</strong>
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</p>Diop, Ayisha, Abbas, Dina, Martin, Roxanne
|
|
et al. (2020) A double-blind, randomized controlled trial to explore oral tranexamic acid as adjunct for the treatment for postpartum hemorrhage. Reproductive Health
|
|
17(1): 34 [<a href="/pmc/articles/PMC7060559/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7060559</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/32143721" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32143721</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng235er15.s1.ref6"><p id="p-223">
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<strong>Ducloy-Bouthers 2011</strong>
|
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</p>Ducloy-Bouthors, Anne-Sophie, Jude, Brigitte, Duhamel, Alain
|
|
et al. (2011) High-dose tranexamic acid reduces blood loss in postpartum haemorrhage. Critical care (London, England)
|
|
15(2): r117 [<a href="/pmc/articles/PMC3219400/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3219400</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/21496253" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21496253</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng235er15.s1.ref7"><p id="p-224">
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<strong>Hofmeyr 2004</strong>
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</p>Hofmeyr, G. Justus, Ferreira, Sandra, Mangesi, Lindeka
|
|
et al. (2004) Misoprostol for treating postpartum haemorrhage: A randomized controlled trial [ISRCTN72263357]. BMC Pregnancy and Childbirth
|
|
4: 16 [<a href="/pmc/articles/PMC514549/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC514549</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/15298718" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15298718</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng235er15.s1.ref8"><p id="p-225">
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<strong>Javadi 2015</strong>
|
|
</p>Javadi
|
|
E, Sadeghipour
|
|
Z, Barikani
|
|
A
|
|
et al. (2015) Tranexamic Acid in the Control of Uterine Atony During Labor. Biotech Health Sci
|
|
2(2): e26898</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng235er15.s1.ref9"><p id="p-226">
|
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<strong>Kumari 2022</strong>
|
|
</p>Kumari, A.; Rohatgi, R.
|
|
et al; (2022) A Double Blinded Randomised Clinical Trial to Compare the Effect of Intravenous Tranexamic Acid and Misoprostol for Postpartum Haemorrhage. European Journal of Molecular and Clinical Medicine
|
|
9(1): 539–545</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng235er15.s1.ref10"><p id="p-227">
|
|
<strong>Lokugamage 2001</strong>
|
|
</p>Lokugamage, A. U., Sullivan, K. R., Niculescu, I.
|
|
et al. (2001) A randomized study comparing rectally administered misoprostol versus Syntometrine combined with an oxytocin infusion for the cessation of primary post partum hemorrhage. Acta obstetricia et gynecologica Scandinavica
|
|
80(9): 835–9 [<a href="https://pubmed.ncbi.nlm.nih.gov/11531635" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 11531635</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng235er15.s1.ref11"><p id="p-228">
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<strong>Maged 2016</strong>
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</p>Maged, A. M.; Hassan, A. M.; Shehata, N. A. (2016) Carbetocin versus oxytocin in the management of atonic post partum haemorrhage (PPH) after vaginal birth: a randomised controlled trial. Archives of gynecology and obstetrics
|
|
293(5): 993–999 [<a href="https://pubmed.ncbi.nlm.nih.gov/26511939" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26511939</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng235er15.s1.ref12"><p id="p-229">
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<strong>Mousa 2014</strong>
|
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</p>Mousa, Hatem A., Blum, Jennifer, Abou El Senoun, Ghada
|
|
et al. (2014) Treatment for primary postpartum haemorrhage. The Cochrane database of systematic reviews: cd003249 [<a href="/pmc/articles/PMC6483801/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6483801</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/24523225" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24523225</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng235er15.s1.ref13"><p id="p-230">
|
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<strong>Sahhaf 2014</strong>
|
|
</p>Sahhaf, Farnaz, Abbasalizadeh, Shamsi, Ghojazadeh, Morteza
|
|
et al. (2014) Comparison effect of intravenous tranexamic acid and misoprostol for postpartum haemorrhage. Nigerian medical journal : journal of the Nigeria Medical Association
|
|
55(4): 348–53 [<a href="/pmc/articles/PMC4124551/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4124551</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/25114373" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25114373</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng235er15.s1.ref14"><p id="p-231">
|
|
<strong>Shakur 2017</strong>
|
|
</p>Shakur, Haleema, Roberts, Ian, Fawole, Bukola
|
|
et al. (2017) Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial. The Lancet
|
|
389(10084): 2105–2116 [<a href="/pmc/articles/PMC5446563/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5446563</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/28456509" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28456509</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng235er15.s1.ref15"><p id="p-232">
|
|
<strong>Shakur 2018</strong>
|
|
</p>Shakur, H., Beaumont, D., Pavord, S.
|
|
et al. (2018) Antifibrinolytic drugs for treating primary postpartum haemorrhage. Cochrane Database of Systematic Reviews [<a href="/pmc/articles/PMC6491317/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6491317</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/29462500" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29462500</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng235er15.s1.ref16"><p id="p-233">
|
|
<strong>Walraven 2004</strong>
|
|
</p>Walraven, Gijs, Dampha, Yusupha, Bittaye, Bubacarr
|
|
et al. (2004) Misoprostol in the treatment of postpartum haemorrhage in addition to routine management: a placebo randomised controlled trial. BJOG : an international journal of obstetrics and gynaecology
|
|
111(9): 1014–7 [<a href="https://pubmed.ncbi.nlm.nih.gov/15327620" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15327620</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng235er15.s1.ref17"><p id="p-234">
|
|
<strong>Wang 2020</strong>
|
|
</p>Wang, Li; Jiang, Hong-Mei; Yang, Rui-Rui (2020) Carboprost tromethamine prevents caesarean section-associated postpartum hemorrhage. Tropical Journal of Pharmaceutical Research
|
|
19(4): 899–904</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng235er15.s1.ref18"><p id="p-235">
|
|
<strong>Widmer 2010</strong>
|
|
</p>Widmer
|
|
M, Blum
|
|
J, Hofmeyr
|
|
GJ
|
|
et al. (2010) Misoprostol as an adjunct to standard uterotonics for treatment of post-partum haemorrhage: a multicentre, double-blind randomised trial. Lancet (London, England)
|
|
375(9728): 1808–1813 [<a href="https://pubmed.ncbi.nlm.nih.gov/20494730" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20494730</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng235er15.s1.ref19"><p id="p-236">
|
|
<strong>Winikoff 2010</strong>
|
|
</p>Winikoff, Beverly, Dabash, Rasha, Durocher, Jill
|
|
et al. (2010) Treatment of post-partum haemorrhage with sublingual misoprostol versus oxytocin in women not exposed to oxytocin during labour: a double-blind, randomised, non-inferiority trial. Lancet (London, England)
|
|
375(9710): 210–6 [<a href="https://pubmed.ncbi.nlm.nih.gov/20060161" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20060161</span></a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng235er15.s1.ref20"><p id="p-237">
|
|
<strong>Zeng 2022</strong>
|
|
</p>Zeng, X.; Huang, D.; Luo, X.; Gong, H.; Wang, X.X.; Comparison of Clinical Effects of Intravenous Tranexamic Acid and Carbetocin in the Treatment of Postpartum Hemorrhage; Indian Journal of Pharmaceutical Sciences; 2022; vol. 84; 158–162</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng235er15.s1.ref21"><p id="p-238">
|
|
<strong>Zuberi 2008</strong>
|
|
</p>Zuberi, Nadeem F., Durocher, Jill, Blum, Jennifer
|
|
et al. (2008) Misoprostol in addition to routine treatment of postpartum hemorrhage: A hospital-based randomized-controlled trial in Karachi, Pakistan. BMC Pregnancy and Childbirth
|
|
8: 40 [<a href="/pmc/articles/PMC2529259/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC2529259</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/18718007" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 18718007</span></a>]</div></p></li></ul></div><div id="niceng235er15.s1.rl.r1.2"><h4>Economic</h4><ul class="simple-list"><li class="half_rhythm"><p><div class="bk_ref" id="niceng235er15.s1.ref22"><p id="p-239">
|
|
<strong>Sudhof 2019</strong>
|
|
</p>Sudoh, Leanna S., Shainker, Scott A., Einerson, Brett D. (2019). Tranexamic acid in the routine treatment of postpartum hemorrhage in the United States: a cost-effectiveness analysis. Am J Obstet Gynecol
|
|
221(3) :275.e1–275.e12. doi: 10.1016/j.ajog.2019.06.030. Epub 2019 Jun 18. [<a href="https://pubmed.ncbi.nlm.nih.gov/31226298" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31226298</span></a>] [<a href="http://dx.crossref.org/10.1016/j.ajog.2019.06.030" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng235er15.s1.ref23"><p id="p-240">
|
|
<strong>Howard 2022</strong>
|
|
</p>Howard
|
|
DC, Jones
|
|
AE, Skeith
|
|
A, et al. Tranexamic acid for the treatment of postpartum hemorrhage: a cost-effectiveness analysis. Am J Obstet Gynecol MFM
|
|
2022;4:100588 [<a href="https://pubmed.ncbi.nlm.nih.gov/35124299" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 35124299</span></a>]</div></p></li></ul></div></ul></div></div><div id="appendixesappgroup1"><h2 id="_appendixesappgroup1_">Appendices</h2><div id="niceng235er15.appa"><h3>Appendix A. Review protocols</h3><p id="niceng235er15.appa.et1"><a href="/books/NBK596278/bin/niceng235er15-appa-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Review protocol for review question: What is the effectiveness of pharmacological treatments for the management of postpartum haemorrhage?</a><span class="small"> (PDF, 213K)</span></p></div><div id="niceng235er15.appb"><h3>Appendix B. Literature search strategies</h3><p id="niceng235er15.appb.et1"><a href="/books/NBK596278/bin/niceng235er15-appb-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Literature search strategies for review question: What is the effectiveness of pharmacological treatments for the management of postpartum haemorrhage?</a><span class="small"> (PDF, 172K)</span></p></div><div id="niceng235er15.appc"><h3>Appendix C. Effectiveness evidence study selection</h3><p id="niceng235er15.appc.et1"><a href="/books/NBK596278/bin/niceng235er15-appc-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Study selection for: What is the effectiveness of pharmacological treatments for the management of postpartum haemorrhage?</a><span class="small"> (PDF, 227K)</span></p></div><div id="niceng235er15.appd"><h3>Appendix D. Evidence tables</h3><p id="niceng235er15.appd.et1"><a href="/books/NBK596278/bin/niceng235er15-appd-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Evidence tables for review question: What is the effectiveness of pharmacological treatments for the management of postpartum haemorrhage?</a><span class="small"> (PDF, 454K)</span></p></div><div id="niceng235er15.appe"><h3>Appendix E. Forest plots</h3><p id="niceng235er15.appe.et1"><a href="/books/NBK596278/bin/niceng235er15-appe-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Forest plots for review question: What is the effectiveness of pharmacological treatments for the management of postpartum haemorrhage?</a><span class="small"> (PDF, 277K)</span></p></div><div id="niceng235er15.appf"><h3>Appendix F. GRADE tables</h3><p id="niceng235er15.appf.et1"><a href="/books/NBK596278/bin/niceng235er15-appf-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">GRADE tables for review question: What is the effectiveness of pharmacological treatments for the management of postpartum haemorrhage?</a><span class="small"> (PDF, 374K)</span></p></div><div id="niceng235er15.appg"><h3>Appendix G. Economic evidence study selection</h3><p id="niceng235er15.appg.et1"><a href="/books/NBK596278/bin/niceng235er15-appg-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Economic study selection for: What is the effectiveness of pharmacological treatments for the management of postpartum haemorrhage?</a><span class="small"> (PDF, 220K)</span></p></div><div id="niceng235er15.apph"><h3>Appendix H. Economic evidence tables</h3><p id="niceng235er15.apph.et1"><a href="/books/NBK596278/bin/niceng235er15-apph-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Economic evidence tables for review question: What is the effectiveness of pharmacological treatments for the management of postpartum haemorrhage?</a><span class="small"> (PDF, 198K)</span></p></div><div id="niceng235er15.appi"><h3>Appendix I. Economic model</h3><div id="niceng235er15.appi.s1"><h4>Economic model for review question: What is the effectiveness of pharmacological treatments for the management of postpartum haemorrhage?</h4><p>No economic analysis was conducted for this review question.</p></div></div><div id="niceng235er15.appj"><h3>Appendix J. Excluded studies</h3><div id="niceng235er15.appj.s1"><h4>Excluded studies for review question: What is the effectiveness of pharmacological treatments for the management of postpartum haemorrhage?</h4></div><div id="niceng235er15.appj.s2"><h4>Excluded effectiveness studies</h4><p id="niceng235er15.appj.tab1"><a href="/books/NBK596278/table/niceng235er15.appj.tab1/?report=objectonly" target="object" rid-ob="figobniceng235er15appjtab1" class="figpopup">Table 16. Excluded studies and reasons for their exclusion</a></p></div><div id="niceng235er15.appj.s3"><h4>Excluded economic studies</h4><p id="niceng235er15.appj.tab2"><a href="/books/NBK596278/table/niceng235er15.appj.tab2/?report=objectonly" target="object" rid-ob="figobniceng235er15appjtab2" class="figpopup">Table 17. Excluded studies and reasons for their exclusion</a></p></div></div><div id="niceng235er15.appk"><h3>Appendix K. Research recommendations – full details</h3><p id="niceng235er15.appk.et1"><a href="/books/NBK596278/bin/niceng235er15-appk-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Research recommendations for review question: What is the effectiveness of pharmacological treatments for the management of postpartum haemorrhage?</a><span class="small"> (PDF, 139K)</span></p></div></div></div><div class="fm-sec"><div><p>Final</p></div><div><p>Evidence reviews underpinning recommendations 1.10.34 and 1.10.35 and a research recommendation in the NICE guideline</p><p>These evidence reviews were developed by NICE</p></div><div><p><b>Disclaimer</b>: The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The recommendations in this guideline are not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.</p><p>Local commissioners and/or providers have a responsibility to enable the guideline to be applied when individual health professionals and their patients or service users wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with compliance with those duties.</p><p>NICE guidelines cover health and care in England. Decisions on how they apply in other UK countries are made by ministers in the <a href="https://www.gov.wales/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Welsh Government</a>, <a href="http://www.scotland.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Scottish Government</a>, and <a href="http://www.northernireland.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Northern Ireland Executive</a>. All NICE guidance is subject to regular review and may be updated or withdrawn.</p></div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright</a> © NICE 2023.</div><div class="small"><span class="label">Bookshelf ID: NBK596278</span><span class="label">PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/37856627" title="PubMed record of this title" ref="pagearea=meta&targetsite=entrez&targetcat=link&targettype=pubmed">37856627</a></span></div></div><div class="small-screen-prev"></div><div class="small-screen-next"></div></article><article data-type="table-wrap" id="figobniceng235er15tab1"><div id="niceng235er15.tab1" class="table"><h3><span class="label">Table 1</span><span class="title">Summary of the protocol (PICO table)</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK596278/table/niceng235er15.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng235er15.tab1_lrgtbl__"><table><tbody><tr><th id="hd_b_niceng235er15.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><td headers="hd_b_niceng235er15.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul><li class="half_rhythm"><div>Women who have given birth to a single baby at term (37 to 42 weeks of pregnancy) and who do not have any pre-existing medical conditions or antenatal conditions that predispose to a higher risk birth</div></li><li class="half_rhythm"><div>Women whose baby has not been identified before labour to be at high risk of adverse outcomes</div></li><li class="half_rhythm"><div>Women with a diagnosis of primary postpartum haemorrhage within the first 24 hours after giving birth, defined as any of the following:
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<ul class="circle"><li class="half_rhythm"><div>blood loss over 500mL</div></li><li class="half_rhythm"><div>postpartum haemorrhage requiring blood transfusion</div></li><li class="half_rhythm"><div>clinically defined postpartum haemorrhage</div></li></ul></div></li></ul></td></tr><tr><th id="hd_b_niceng235er15.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention</th><td headers="hd_b_niceng235er15.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pharmacological treatments administered by any route and regimen:
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<ul><li class="half_rhythm"><div>Antifibrinolytic drugs (including, but not limited to: aprotinin, tranexamic acid)</div></li><li class="half_rhythm"><div>Uterotonic drugs (carbetocin, ergometrine, misoprostrol, oxytocin, pitocin, prostaglandins (such as carboprost), syntometrine</div></li><li class="half_rhythm"><div>A combination of the drugs listed above</div></li></ul></td></tr><tr><th id="hd_b_niceng235er15.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comparison</th><td headers="hd_b_niceng235er15.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul><li class="half_rhythm"><div>Any of the above interventions compared to each other</div></li><li class="half_rhythm"><div>Placebo</div></li></ul></td></tr><tr><th id="hd_b_niceng235er15.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcome</th><td headers="hd_b_niceng235er15.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><b>Critical</b>
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<ul><li class="half_rhythm"><div>Maternal death</div></li><li class="half_rhythm"><div>Blood loss volume</div></li><li class="half_rhythm"><div>Coagulation/coagulopathy/occlusive events/embolic event</div></li></ul>
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<b>Important</b>
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<ul><li class="half_rhythm"><div>Need for additional pharmacological management of haemorrhage</div></li><li class="half_rhythm"><div>Need for additional surgical management of haemorrhage (for example hysterectomy, balloon tamponade, sutures, interventional radiology)</div></li><li class="half_rhythm"><div>Breastfeeding</div></li><li class="half_rhythm"><div>Women’s and partner’s experience and satisfaction of labour and birth and postnatal period</div></li></ul></td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng235er15tab2"><div id="niceng235er15.tab2" class="table"><h3><span class="label">Table 2</span><span class="title">Summary of included studies</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK596278/table/niceng235er15.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng235er15.tab2_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng235er15.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th id="hd_h_niceng235er15.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><th id="hd_h_niceng235er15.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention</th><th id="hd_h_niceng235er15.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comparison</th><th id="hd_h_niceng235er15.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes</th></tr></thead><tbody><tr><td headers="hd_h_niceng235er15.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>
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<a class="bibr" href="#niceng235er15.s1.ref1" rid="niceng235er15.s1.ref1">Abbas 2019</a>
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</p>
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<p>Randomised controlled trial</p>
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<p>Pakistan</p>
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</td><td headers="hd_h_niceng235er15.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>N = 87 women with postpartum haemorrhage</p>
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<p>Mixed parity</p>
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<p>Women received oral misoprostol prophylaxis</p>
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</td><td headers="hd_h_niceng235er15.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">800 microgram misoprostol</td><td headers="hd_h_niceng235er15.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Placebo</td><td headers="hd_h_niceng235er15.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul><li class="half_rhythm"><div>Maternal death</div></li><li class="half_rhythm"><div>Need for additional pharmacological management</div></li></ul></td></tr><tr><td headers="hd_h_niceng235er15.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>
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<a class="bibr" href="#niceng235er15.s1.ref2" rid="niceng235er15.s1.ref2">Abbas 2020</a>
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</p>
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<p>Randomised controlled trial</p>
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<p>Afghanistan</p>
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</td><td headers="hd_h_niceng235er15.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>N = 79 women with postpartum haemorrhage</p>
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<p>Mixed parity</p>
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<p>Women received oral misoprostol prophylaxis</p>
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</td><td headers="hd_h_niceng235er15.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">800 microgram misoprostol</td><td headers="hd_h_niceng235er15.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Placebo</td><td headers="hd_h_niceng235er15.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul><li class="half_rhythm"><div>Maternal death</div></li><li class="half_rhythm"><div>Need for additional pharmacological management</div></li><li class="half_rhythm"><div>Need for additional surgical management</div></li></ul></td></tr><tr><td headers="hd_h_niceng235er15.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>
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<a class="bibr" href="#niceng235er15.s1.ref4" rid="niceng235er15.s1.ref4">Dallaku 2019</a>
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</p>
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<p>Randomised controlled trial</p>
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<p>Albania</p>
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</td><td headers="hd_h_niceng235er15.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>N = 187 women with postpartum haemorrhage</p>
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<p>Mixed parity</p>
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<p>96% of women received uterotonic prophylaxis</p>
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<p>Part of the larger Shakur</p>
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</td><td headers="hd_h_niceng235er15.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1 g TXA</td><td headers="hd_h_niceng235er15.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Placebo</td><td headers="hd_h_niceng235er15.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul><li class="half_rhythm"><div>Coagulation</div></li></ul></td></tr><tr><td headers="hd_h_niceng235er15.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>
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<a class="bibr" href="#niceng235er15.s1.ref5" rid="niceng235er15.s1.ref5">Diop 2020</a>
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</p>
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<p>Randomised controlled trial</p>
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<p>Senegal and Vietnam</p>
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</td><td headers="hd_h_niceng235er15.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>N = 260 women with postpartum haemorrhage</p>
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<p>Mixed parity</p>
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<p>All women received oxytocin prophylaxis</p>
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</td><td headers="hd_h_niceng235er15.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1950 mg TXA + 800 microgram misoprostol</td><td headers="hd_h_niceng235er15.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Placebo + 800 microgram misoprostol</td><td headers="hd_h_niceng235er15.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul><li class="half_rhythm"><div>Maternal death</div></li><li class="half_rhythm"><div>Blood loss volume</div></li><li class="half_rhythm"><div>Need for additional pharmacological management</div></li><li class="half_rhythm"><div>Need for additional surgical management</div></li></ul></td></tr><tr><td headers="hd_h_niceng235er15.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Javadi 2012</p>
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<p>Randomised controlled trial</p>
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<p>Iran</p>
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</td><td headers="hd_h_niceng235er15.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>N = 90 women with postpartum haemorrhage</p>
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<p>Mixed parity</p>
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<p>All women received oxytocin prophylaxis</p>
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</td><td headers="hd_h_niceng235er15.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1 g TXA + 20 units oxytocin infusion + 0.2 mg ergometrine</td><td headers="hd_h_niceng235er15.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>20 units oxytocin + 0.2 mg ergometrine</p>
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<p>Route of delivery of oxytocin not specified</p>
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</td><td headers="hd_h_niceng235er15.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul><li class="half_rhythm"><div>Blood loss volume</div></li><li class="half_rhythm"><div>Occlusive event</div></li><li class="half_rhythm"><div>Need for additional surgical management</div></li></ul></td></tr><tr><td headers="hd_h_niceng235er15.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>
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<a class="bibr" href="#niceng235er15.s1.ref9" rid="niceng235er15.s1.ref9">Kumari 2022</a>
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</p>
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<p>Randomised controlled trial</p>
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<p>India</p>
|
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</td><td headers="hd_h_niceng235er15.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>N=80 women with postpartum haemorrhage</p>
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<p>Mixed parity</p>
|
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<p>All women received oxytocin prophylaxis</p>
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</td><td headers="hd_h_niceng235er15.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1g TXA</td><td headers="hd_h_niceng235er15.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">5 rectal misoprostol pills at 200 microgram</td><td headers="hd_h_niceng235er15.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul><li class="half_rhythm"><div>Blood loss volume</div></li></ul></td></tr><tr><td headers="hd_h_niceng235er15.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>
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<a class="bibr" href="#niceng235er15.s1.ref11" rid="niceng235er15.s1.ref11">Maged 2016</a>
|
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</p>
|
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<p>Randomised controlled trial</p>
|
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<p>Egypt</p>
|
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</td><td headers="hd_h_niceng235er15.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>N = 100 women with postpartum haemorrhage</p>
|
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<p>Mixed parity</p>
|
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<p>It is suggested women received ergometrine as prophylaxis</p>
|
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</td><td headers="hd_h_niceng235er15.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">100 microgram carbetocin</td><td headers="hd_h_niceng235er15.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">5 units IV oxytocin</td><td headers="hd_h_niceng235er15.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<ul><li class="half_rhythm"><div>Maternal death</div></li><li class="half_rhythm"><div>Blood loss volume</div></li><li class="half_rhythm"><div>Need for additional pharmacological management</div></li><li class="half_rhythm"><div>Need for additional surgical management</div></li></ul></td></tr><tr><td headers="hd_h_niceng235er15.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<p>
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<a class="bibr" href="#niceng235er15.s1.ref12" rid="niceng235er15.s1.ref12">Mousa 2014</a>
|
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</p>
|
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<p>Cochrane systematic review</p>
|
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<p>Argentina, Burkina Faso, Ecuador, Egypt, Gambia, Pakistan, South Africa, Thailand, Turkey, Vietnam</p>
|
|
</td><td headers="hd_h_niceng235er15.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>K = 7 (<a class="bibr" href="#niceng235er15.s1.ref3" rid="niceng235er15.s1.ref3">Blum 2010</a>, <a class="bibr" href="#niceng235er15.s1.ref7" rid="niceng235er15.s1.ref7">Hofmeyr 2004</a>, <a class="bibr" href="#niceng235er15.s1.ref10" rid="niceng235er15.s1.ref10">Lokugamage 2001</a>, <a class="bibr" href="#niceng235er15.s1.ref16" rid="niceng235er15.s1.ref16">Walraven 2004</a>, <a class="bibr" href="#niceng235er15.s1.ref18" rid="niceng235er15.s1.ref18">Widmer 2010</a>, <a class="bibr" href="#niceng235er15.s1.ref19" rid="niceng235er15.s1.ref19">Winikoff 2010</a>, <a class="bibr" href="#niceng235er15.s1.ref21" rid="niceng235er15.s1.ref21">Zuberi 2008</a>)</p>
|
|
<p>N=3738 women with postpartum haemorrhage</p>
|
|
<p>Mixed parity</p>
|
|
<p>Some women received prophylaxis</p>
|
|
</td><td headers="hd_h_niceng235er15.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Misoprostol (600 microgram or 800 microgram or 1000 microgram)</td><td headers="hd_h_niceng235er15.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Placebo</p>
|
|
<p>IV oxytocin + placebo</p>
|
|
<p>Syntometrine (IM oxytocin and ergometrine plus) + IV infusion oxytocin + placebo</p>
|
|
</td><td headers="hd_h_niceng235er15.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<ul><li class="half_rhythm"><div>Maternal death</div></li><li class="half_rhythm"><div>Blood loss volume</div></li><li class="half_rhythm"><div>Need for additional pharmacological management</div></li><li class="half_rhythm"><div>Need for additional surgical management</div></li></ul></td></tr><tr><td headers="hd_h_niceng235er15.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<a class="bibr" href="#niceng235er15.s1.ref15" rid="niceng235er15.s1.ref15">Shakur 2018</a>
|
|
</p>
|
|
<p>Cochrane systematic review</p>
|
|
<p>Albania, Bangladesh, Burkina Faso, Cameroon, Colombia, Cote d’Ivoire, Democratic Republic of Congo, Egypt, Ethiopia, France, Ghana, Iran, Jamaica, Kenya, Nepal, Nigeria, Pakistan, Papua New Guinea, Sudan, Tanzania, United Kingdom, Uganda, Zambia</p>
|
|
</td><td headers="hd_h_niceng235er15.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>K = 3 (<a class="bibr" href="#niceng235er15.s1.ref6" rid="niceng235er15.s1.ref6">Ducloy-Bouthers 2011</a>, <a class="bibr" href="#niceng235er15.s1.ref13" rid="niceng235er15.s1.ref13">Sahhaf 2014</a>, <a class="bibr" href="#niceng235er15.s1.ref14" rid="niceng235er15.s1.ref14">Shakur 2017</a>)</p>
|
|
<p>N = 20412 women with postpartum haemorrhage</p>
|
|
<p>Mixed parity</p>
|
|
<p>Women received oxytocin prophylaxis</p>
|
|
</td><td headers="hd_h_niceng235er15.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1 g or 4 g TXA</td><td headers="hd_h_niceng235er15.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Placebo</p>
|
|
<p>No TXA</p>
|
|
</td><td headers="hd_h_niceng235er15.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<ul><li class="half_rhythm"><div>Maternal death</div></li><li class="half_rhythm"><div>Blood loss volume</div></li><li class="half_rhythm"><div>Occlusive events</div></li><li class="half_rhythm"><div>Need for additional pharmacological management</div></li><li class="half_rhythm"><div>Need for additional surgical management</div></li></ul></td></tr><tr><td headers="hd_h_niceng235er15.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<a class="bibr" href="#niceng235er15.s1.ref17" rid="niceng235er15.s1.ref17">Wang 2020</a>
|
|
</p>
|
|
<p>Randomised controlled trial</p>
|
|
<p>China</p>
|
|
</td><td headers="hd_h_niceng235er15.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>N = 100 women with postpartum haemorrhage</p>
|
|
<p>Mixed parity</p>
|
|
<p>Women received oxytocin prophylaxis</p>
|
|
</td><td headers="hd_h_niceng235er15.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">250 microgram carboprost tromethamine</td><td headers="hd_h_niceng235er15.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">20-50 units continuous oxytocin</td><td headers="hd_h_niceng235er15.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<ul><li class="half_rhythm"><div>Blood loss volume</div></li></ul></td></tr><tr><td headers="hd_h_niceng235er15.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<a class="bibr" href="#niceng235er15.s1.ref20" rid="niceng235er15.s1.ref20">Zeng 2022</a>
|
|
</p>
|
|
<p>Randomised controlled trial</p>
|
|
<p>China</p>
|
|
</td><td headers="hd_h_niceng235er15.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>N = 80 women with postpartum haemorrhage</p>
|
|
<p>Parity not reported</p>
|
|
<p>Women received oxytocin prophylaxis</p>
|
|
</td><td headers="hd_h_niceng235er15.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">100 milligram carbetocin IV (reported in paper as this; believed to be error and dose actually 100 micrograms)</td><td headers="hd_h_niceng235er15.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">0.5g TXA IV. Second dose given after 1 hour</td><td headers="hd_h_niceng235er15.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<ul><li class="half_rhythm"><div>Blood loss volume</div></li><li class="half_rhythm"><div>Coagulation</div></li></ul></td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">TXA: tranexamic acid; IM: intramuscular; IV: intravenous</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng235er15tab3"><div id="niceng235er15.tab3" class="table"><h3><span class="label">Table 3</span><span class="title">Economic evidence profile of a systematic review of economic evaluations of pharmacological treatments for the management of postpartum haemorrhage</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK596278/table/niceng235er15.tab3/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng235er15.tab3_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng235er15.tab3_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_niceng235er15.tab3_1_1_1_1" style="text-align:left;vertical-align:bottom;">Study</th><th id="hd_h_niceng235er15.tab3_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_niceng235er15.tab3_1_1_1_2" style="text-align:left;vertical-align:bottom;">Limitations</th><th id="hd_h_niceng235er15.tab3_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_niceng235er15.tab3_1_1_1_3" style="text-align:left;vertical-align:bottom;">Applicability</th><th id="hd_h_niceng235er15.tab3_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_niceng235er15.tab3_1_1_1_4" style="text-align:left;vertical-align:bottom;">Other comments</th><th id="hd_h_niceng235er15.tab3_1_1_1_5" colspan="3" rowspan="1" style="text-align:left;vertical-align:bottom;">Incremental<sup>1</sup></th><th id="hd_h_niceng235er15.tab3_1_1_1_6" rowspan="2" colspan="1" headers="hd_h_niceng235er15.tab3_1_1_1_6" style="text-align:left;vertical-align:bottom;">Uncertainty</th></tr><tr><th headers="hd_h_niceng235er15.tab3_1_1_1_5" id="hd_h_niceng235er15.tab3_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Costs</th><th headers="hd_h_niceng235er15.tab3_1_1_1_5" id="hd_h_niceng235er15.tab3_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Effect</th><th headers="hd_h_niceng235er15.tab3_1_1_1_5" id="hd_h_niceng235er15.tab3_1_1_2_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cost effectivenss</th></tr></thead><tbody><tr><td headers="hd_h_niceng235er15.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<a class="bibr" href="#niceng235er15.s1.ref22" rid="niceng235er15.s1.ref22">Sudhof 2019</a>
|
|
</p>
|
|
<p>Tranexamic acid in the routine treatment of postpartum hemorrhage in the United States: a cost-effectiveness analysis</p>
|
|
</td><td headers="hd_h_niceng235er15.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Potentially serious limitations<sup>2</sup><sup>,</sup><sup>3</sup><sup>,</sup><sup>4</sup><sup>,</sup><sup>5</sup></td><td headers="hd_h_niceng235er15.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Partially applicable<sup>6</sup></td><td headers="hd_h_niceng235er15.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study employed a decision-analytic model with average female life expectancy</td><td headers="hd_h_niceng235er15.tab3_1_1_1_5 hd_h_niceng235er15.tab3_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>
|
|
<u>Tranexamic acid given at any time</u>
|
|
</b>
|
|
</p>
|
|
<p>$626</p>
|
|
<p>
|
|
<b>
|
|
<u>Tranexamic acid given within 3 hours of birth</u>
|
|
</b>
|
|
</p>
|
|
<p>$532</p>
|
|
</td><td headers="hd_h_niceng235er15.tab3_1_1_1_5 hd_h_niceng235er15.tab3_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>
|
|
<u>Tranexamic acid given at any time</u>
|
|
</b>
|
|
</p>
|
|
<p>0.03 QALYs</p>
|
|
<p>
|
|
<b>
|
|
<u>Tranexamic acid given within 3 hours of birth</u>
|
|
</b>
|
|
</p>
|
|
<p>0.04 QALYs</p>
|
|
</td><td headers="hd_h_niceng235er15.tab3_1_1_1_5 hd_h_niceng235er15.tab3_1_1_2_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Tranexamic acid given within 3 hours of birth dominates</td><td headers="hd_h_niceng235er15.tab3_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Tranexamic strategies had a greater than 99.9% probability of being cost saving</p>
|
|
<p>One-way threshold analysis indicated that the results were sensitive to the risk reduction in haemorrhage related mortality – tranexamic acid remained cost saving providing relative reduction in postpartum haemorrhage was >4.7%</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<a class="bibr" href="#niceng235er15.s1.ref23" rid="niceng235er15.s1.ref23">Howard 2022</a>
|
|
</td><td headers="hd_h_niceng235er15.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Potentially serious limitations<sup>2</sup><sup>,</sup><sup>4</sup><sup>,</sup><sup>5</sup></td><td headers="hd_h_niceng235er15.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Partially applicable<sup>6</sup><sup>,</sup><sup>7</sup><sup>,</sup><sup>8</sup></td><td headers="hd_h_niceng235er15.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study employed a decision-analytic model with average female life expectancy</td><td headers="hd_h_niceng235er15.tab3_1_1_1_5 hd_h_niceng235er15.tab3_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>
|
|
<u>Early administration of Tranexamic acid</u>
|
|
</b>
|
|
</p>
|
|
<p>−$154</p>
|
|
<p>
|
|
<b>
|
|
<u>Tranexamic acid given within 3 hours of diagnosis of PPH</u>
|
|
</b>
|
|
</p>
|
|
<p>−$232</p>
|
|
</td><td headers="hd_h_niceng235er15.tab3_1_1_1_5 hd_h_niceng235er15.tab3_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>
|
|
<u>Early administration of Tranexamic acid</u>
|
|
</b>
|
|
</p>
|
|
<p>0.003 QALYs</p>
|
|
<p>
|
|
<b>
|
|
<u>Tranexamic acid given within 3 hours of diagnosis of PPH</u>
|
|
</b>
|
|
</p>
|
|
<p>0.004 QALYs</p>
|
|
</td><td headers="hd_h_niceng235er15.tab3_1_1_1_5 hd_h_niceng235er15.tab3_1_1_2_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Tranexamic acid given within 3 hours of PPH diagnosis dominates</td><td headers="hd_h_niceng235er15.tab3_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Early administration of tranexamic acid had a 99.8% probability of being cost-effective relative to no tranexamic acid</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>1</dt><dd><div id="niceng235er15.tab3_1"><p class="no_margin">Relative to no tranexamic acid</p></div></dd></dl><dl class="bkr_refwrap"><dt>2</dt><dd><div id="niceng235er15.tab3_2"><p class="no_margin">The model does not include all relevant comparators</p></div></dd></dl><dl class="bkr_refwrap"><dt>3</dt><dd><div id="niceng235er15.tab3_3"><p class="no_margin">Cost of maternal death includes a US malpractice suit</p></div></dd></dl><dl class="bkr_refwrap"><dt>4</dt><dd><div id="niceng235er15.tab3_4"><p class="no_margin">In the base case analysis the model assumes the same relative risk reduction as in the WOMAN trial although the benefit of tranexamic acid may be less in better resourced health care systems</p></div></dd></dl><dl class="bkr_refwrap"><dt>5</dt><dd><div id="niceng235er15.tab3_5"><p class="no_margin">Outcomes in the WOMAN trial that did not show a statistically significant reduction were excluded from the model</p></div></dd></dl><dl class="bkr_refwrap"><dt>6</dt><dd><div id="niceng235er15.tab3_6"><p class="no_margin">The cost-effectiveness model was designed to reflect the management of postpartum haemorrhage in the United States healthcare setting</p></div></dd></dl><dl class="bkr_refwrap"><dt>7</dt><dd><div id="niceng235er15.tab3_7"><p class="no_margin">Costing from a societal perspective is different to the NICE reference case</p></div></dd></dl><dl class="bkr_refwrap"><dt>8</dt><dd><div id="niceng235er15.tab3_8"><p class="no_margin">Analysis assessed cost-effectiveness using a cost-effectiveness threshold of £20,000 per QALY</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng235er15tab4"><div id="niceng235er15.tab4" class="table"><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK596278/table/niceng235er15.tab4/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng235er15.tab4_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng235er15.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Resource</th><th id="hd_h_niceng235er15.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Unit costs</th><th id="hd_h_niceng235er15.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Source</th></tr></thead><tbody><tr><td headers="hd_h_niceng235er15.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Tranexamic acid</td><td headers="hd_h_niceng235er15.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">£3.00<sup>1</sup></td><td headers="hd_h_niceng235er15.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">BNF</td></tr><tr><td headers="hd_h_niceng235er15.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Oxytocin</td><td headers="hd_h_niceng235er15.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">£0.80<sup>2</sup></td><td headers="hd_h_niceng235er15.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">BNF</td></tr><tr><td headers="hd_h_niceng235er15.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Misoprostol</td><td headers="hd_h_niceng235er15.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">£0.84<sup>3</sup></td><td headers="hd_h_niceng235er15.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">BNF</td></tr><tr><td headers="hd_h_niceng235er15.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Syntometrine (oxytocin and ergometrine)</td><td headers="hd_h_niceng235er15.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">£1.57<sup>4</sup></td><td headers="hd_h_niceng235er15.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">BNF</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>1</dt><dd><div id="niceng235er15.tab4_1"><p class="no_margin">Based on dose of 1g and Tranexamic acid 1g/10ml solution for injection ampoules at £15.00 for 5 ampoules</p></div></dd></dl><dl class="bkr_refwrap"><dt>2</dt><dd><div id="niceng235er15.tab4_2"><p class="no_margin">Based on dose of 5 units and Oxytocin 5units/1ml solution for injection ampoules at £4.00 for 5 ampoules</p></div></dd></dl><dl class="bkr_refwrap"><dt>3</dt><dd><div id="niceng235er15.tab4_3"><p class="no_margin">Based on dose of 1,000 micrograms and 200 microgram misoprostol at £10.03 for 60 tablets</p></div></dd></dl><dl class="bkr_refwrap"><dt>4</dt><dd><div id="niceng235er15.tab4_4"><p class="no_margin">Based on dose of 1mL and Syntometrine 500 micrograms/1ml solution for injection ampoules at £7.87 for 5 ampoules</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng235er15appjtab1"><div id="niceng235er15.appj.tab1" class="table"><h3><span class="label">Table 16</span><span class="title">Excluded studies and reasons for their exclusion</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK596278/table/niceng235er15.appj.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng235er15.appj.tab1_lrgtbl__"><table><thead><tr><th id="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th id="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Reason</th></tr></thead><tbody><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
(2017) Tranexamic acid for post-partum haemorrhage in the WOMAN trial. Lancet
|
|
390(10102): 1582–1583 [<a href="https://pubmed.ncbi.nlm.nih.gov/28980955" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28980955</span></a>]
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study design</p>
|
|
<p>Correspondence only to the WOMAN trial</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Anonymous (2001) Misprostol as postpartum oxytocic?. South African Medical Journal
|
|
91(5): 351
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study design</p>
|
|
<p>Editorial comment</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Ayedi, M., Jarraya, A., Smaoui, M.
|
|
et al. (2011) Effect of tranexamic acid on post partum hemorrhage by uterine atony: A preliminary result of a randomized, placebocontrolled trial. European Journal of Anaesthesiology
|
|
28(suppl48): 165
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Conference abstract</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Aziz, Samia, Rossiter, Shania, Homer, Caroline S. E.
|
|
et al. (2021) The cost-effectiveness of tranexamic acid for treatment of postpartum hemorrhage: A systematic review. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics [<a href="/pmc/articles/PMC8596845/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC8596845</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/33621351" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33621351</span></a>]
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study design</p>
|
|
<p>Systematic review of cost effectiveness studies, considered for economics</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Bagheri, Fatemeh Zahra, Azadehrah, Mahboobeh, Shabankhani, Bizhan
|
|
et al. (2022) Rectal vs. sublingual misoprostol in cesarean section: Three-arm, randomized clinical trial. Caspian journal of internal medicine
|
|
13(1): 84–89 [<a href="/pmc/articles/PMC8797813/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC8797813</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/35178212" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 35178212</span></a>]
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Population not in PICO</p>
|
|
<p>Women did not have PPH</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Beigi, A., Tabarestani, H., Moini, A.
|
|
et al. (2009) Sublingual misoprostol versus intravenous oxytocin in the management of postpartum hemorrhage. Tehran university medical journal
|
|
67(8): 556–561
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Population not in PICO</p>
|
|
<p>Not women with post-partum haemorrhage</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Blum, J. (2012) Misoprostol: A proven technology for prevention and treatment of PPH-overview of the clinical evidence. International Journal of Gynecology and Obstetrics
|
|
119(suppl3): 172
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Conference abstract</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Blum, J., Winikoff, B., Raghavan, S.
|
|
et al. (2009) Treatment of postpartum hemorrhage with sublingual misoprostol versus oxytocin: Results from a randomized noninferiority trial among women receiving prophylactic oxytocin. International Journal of Gynecology and Obstetrics
|
|
107(suppl2): S22–S23
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Conference abstract</p>
|
|
<p>Full published results included</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Bouthors, A. S., Hennart, B., Jeanpierre, E.
|
|
et al. (2018) Therapeutic and pharmaco-biological, dose-ranging multicentre trial to determine the optimal dose of TRAnexamic acid to reduce blood loss in haemorrhagic CESarean delivery (TRACES): study protocol for a randomised, double-blind, placebo-controlled trial. Trials
|
|
19(1nopagination) [<a href="/pmc/articles/PMC5831710/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5831710</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/29490682" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29490682</span></a>]
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Trial protocol only</p>
|
|
<p>Full results assessed under <a class="bibr" href="#niceng235er15.appj.ref26" rid="niceng235er15.appj.ref26">Ducloy-Bouthors 2022</a></p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Cao, Yanxia, Sun, Baoli, Gu, Yongzhong
|
|
et al. (2020) Efficacy of misoprostol combined with mifepristone on postpartum hemorrhage and its effects on coagulation function. International Journal of Clinical and Experimental Medicine
|
|
13(4): 2234–2240
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Population not in PICO</p>
|
|
<p>Women do not have post-partum haemorrhage</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Casais, P., Ocampo, C., Salgado, P.
|
|
et al. (2020) Prevalence and management of post partum hemorrhage in latin america: An overview of systematic reviews. Research and Practice in Thrombosis and Haemostasis
|
|
4(suppl1): 1297–1298
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Conference abstract</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
ChiCtr (2018) Therapeutic efficacy and safety of carbetocin on postpartum hemorrhage. <a href="http://www.who.int/trialsearch/Trial2.aspx?TrialID=ChiCTR1800015613" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">http://www<wbr style="display:inline-block"></wbr>​.who.int/trialsearch/Trial2<wbr style="display:inline-block"></wbr>​.aspx?TrialID<wbr style="display:inline-block"></wbr>​=ChiCTR1800015613</a>
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Trial protocol only</p>
|
|
<p>Published results not located</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Cornelissen, Laura, Woodd, Susannah, Shakur-Still, Haleema
|
|
et al. (2019) Secondary analysis of the WOMAN trial to explore the risk of sepsis after invasive treatments for postpartum hemorrhage. International Journal of Gynecology and Obstetrics
|
|
146(2): 231–237 [<a href="/pmc/articles/PMC7814887/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7814887</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/31081140" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31081140</span></a>]
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Outcomes not in PICO</p>
|
|
<p>Secondary analysis of the WOMAN trial</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Ctri (2012) “Role of Tranexamic Acid (TXA) to reduce the bleeding in post delivery cases”. <a href="http://www.who.int/trialsearch/Trial2.aspx?TrialID=CTRI/2012/05/002622" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">http://www<wbr style="display:inline-block"></wbr>​.who.int/trialsearch/Trial2<wbr style="display:inline-block"></wbr>​.aspx?TrialID=CTRI<wbr style="display:inline-block"></wbr>​/2012/05/002622</a>
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Trial protocol only</p>
|
|
<p>Unable to locate full results</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Dao, B., Blum, J., Dabash, R.
|
|
et al. (2009) Side effect profiles for misoprostol and oxytocin in the treatment of postpartum hemorrhage. International Journal of Gynecology and Obstetrics
|
|
107(suppl2): 150
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Conference abstract</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Davis, Steven, Nawab, Aria, van Nispen, Christiaan
|
|
et al. (2020) The Role of Tranexamic Acid in the Management of an Acutely Hemorrhaging Patient. Hospital Pharmacy [<a href="/pmc/articles/PMC8326847/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC8326847</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/34381274" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 34381274</span></a>]
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study design</p>
|
|
<p>Literature review</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Della Corte, Luigi, Saccone, Gabriele, Locci, Mariavittoria
|
|
et al. (2020) Tranexamic acid for treatment of primary postpartum hemorrhage after vaginal delivery: a systematic review and meta-analysis of randomized controlled trials. The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
|
|
33(5): 869–874 [<a href="https://pubmed.ncbi.nlm.nih.gov/30122082" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30122082</span></a>]
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Systematic review</p>
|
|
<p>Not included for primary studies, as a Cochrane review has been included which reports the same RCTs</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Dresang, Lee; Kredit, Sheila; Vellardita, Lia (2019) Does tranexamic acid reduce mortality in women with postpartum hemorrhage?. The Journal of family practice
|
|
68(9): E12–E13 [<a href="https://pubmed.ncbi.nlm.nih.gov/31725142" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31725142</span></a>]
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study design</p>
|
|
<p>Not a systematic review or a randomised controlled trial</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Ducloy-Bouthors, A. S., Baptiste, A., Hennart, B.
|
|
et al. (2017) TRAnexamic acid to reduce blood loss in hemorrhagic CESarean delivery: Therapeutic and pharmaco-biological dose-ranging multicenter randomized double blind placebo controlled study: TRACES trial methodology. Thrombosis Research
|
|
151(supplement1): S112–S113 [<a href="/pmc/articles/PMC5831710/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5831710</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/29490682" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29490682</span></a>]
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Trial protocol only</p>
|
|
<p>Full results not yet published</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Ducloy-Bouthors, A. S., Depret, S., Provost, N.
|
|
et al. (2010) Tranexamic acid reduces blood loss in postpartum haemorrhage. Results from the French randomized controlled study EXADE. Pathophysiology of Haemostasis and Thrombosis
|
|
37(suppl1): a170
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Conference abstract</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Ducloy-Bouthors, A. S., Depret-Mosser, S., Duhamell, A.
|
|
et al. (2011) Tranexamic acid reduces blood loss in post-partum haemorrhage. Thrombosis Research
|
|
127(suppl3): 128
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Conference abstract.</p>
|
|
<p>Full results included in <a class="bibr" href="#niceng235er15.s1.ref6" rid="niceng235er15.s1.ref6">Ducloy-Bouthors 2011</a></p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Ducloy-Bouthors, A. S., Duhamel, A., Broisin, F.
|
|
et al. (2012) Tranexamic acid reduces blood loss in post-partum haemorrhage by reducing hyperfibrinolysis. British journal of anaesthesia
|
|
108: ii191
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Conference abstract.</p>
|
|
<p>Full results included</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Ducloy-Bouthors, A. S., Duhamel, A., Jude, B.
|
|
et al. (2012) High dose tranexamic acid reduces blood loss in post-partum haemorrhage. International Journal of Gynecology and Obstetrics
|
|
119(suppl3): 331
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Conference abstract</p>
|
|
<p>Full results have been included</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Ducloy-Bouthors, A. S., Jeanpierre, E., Hennart, B.
|
|
et al. (2017) TRAnexamic acid to reduce blood loss in haemorrhagic CESarean delivery: Therapeutic and pharmaco-biological dose-ranging multicentre randomised double-blind placebo-controlled study: TRACES trial methodology. Transfusion Medicine
|
|
27(supplement1): 61–62 [<a href="/pmc/articles/PMC5831710/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5831710</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/29490682" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29490682</span></a>]
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Trial protocol only</p>
|
|
<p>Full results assessed under <a class="bibr" href="#niceng235er15.appj.ref26" rid="niceng235er15.appj.ref26">Ducloy-Bouthors 2022</a></p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Ducloy-Bouthors, A., Depret, S., Jude, B.
|
|
et al. (2010) Tranexamic acid reduces blood loss in postpartum haemorrhage. Critical Care
|
|
14(suppl1): S124–S125 [<a href="/pmc/articles/PMC3219400/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3219400</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/21496253" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21496253</span></a>]
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Conference abstract</p>
|
|
<p>Full results included under <a class="bibr" href="#niceng235er15.s1.ref6" rid="niceng235er15.s1.ref6">Ducloy-Bouthors 2011</a></p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<a id="niceng235er15.appj.ref26"></a>Ducloy-Bouthors, Anne-Sophie, Gilliot, Sixtine, Kyheng, Maeva
|
|
et al. (2022) Tranexamic acid dose-response relationship for antifibrinolysis in postpartum haemorrhage during Caesarean delivery: TRACES, a double-blind, placebo-controlled, multicentre, dose-ranging biomarker study. British journal of anaesthesia
|
|
129(6): 937–945 [<a href="/pmc/articles/PMC9748994/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC9748994</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/36243576" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 36243576</span></a>]
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Outcomes not in PICO</p>
|
|
<p>No outcomes of interest matching the protocol</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Euctr, F. R. (2015) Study on the efficacy and safety of a therapeutic strategy of post partum haemorrhage comparing early administration of human fibrinogen versus placebo in patients treated with intravenous prostaglandins following vaginal delivery. <a href="http://www.who.int/trialsearch/Trial2.aspx?TrialID=EUCTR2013-002484-26-FR" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">http://www<wbr style="display:inline-block"></wbr>​.who.int/trialsearch/Trial2<wbr style="display:inline-block"></wbr>​.aspx?TrialID<wbr style="display:inline-block"></wbr>​=EUCTR2013-002484-26-FR</a>
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Trial protocol only</p>
|
|
<p>Full results located but not included as intervention does not meet PICO</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Euctr, F. R. (2015) Study to determine tranxamic acid’s effect on the bleedings that occurs within the haemorrhagic caesarean. <a href="http://www.who.int/trialsearch/Trial2.aspx?TrialID=EUCTR2015-002499-26-FR" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">http://www<wbr style="display:inline-block"></wbr>​.who.int/trialsearch/Trial2<wbr style="display:inline-block"></wbr>​.aspx?TrialID<wbr style="display:inline-block"></wbr>​=EUCTR2015-002499-26-FR</a>
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Trial protocol only</p>
|
|
<p>Full results not yet published</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Euctr, G. B. (2008) Randomized controlled trial comparing the effect of carbetocin vs syntocinon and ergometrine on postpartum haemorrhage in patients undergoing elective caesarean section - C.A.S.E. Trial. <a href="http://www.who.int/trialsearch/Trial2.aspx?TrialID=EUCTR2007-002341-20-GB" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">http://www<wbr style="display:inline-block"></wbr>​.who.int/trialsearch/Trial2<wbr style="display:inline-block"></wbr>​.aspx?TrialID<wbr style="display:inline-block"></wbr>​=EUCTR2007-002341-20-GB</a>
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Trial protocol only</p>
|
|
<p>Full results not located</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Euctr, G. B. (2019) The Carboprost or Oxytocin Postpartum haemorrhage Effectiveness Study. <a href="http://www.who.int/trialsearch/Trial2.aspx?TrialID=EUCTR2018-001829-11-GB" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">http://www<wbr style="display:inline-block"></wbr>​.who.int/trialsearch/Trial2<wbr style="display:inline-block"></wbr>​.aspx?TrialID<wbr style="display:inline-block"></wbr>​=EUCTR2018-001829-11-GB</a>
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Trial protocol only</p>
|
|
<p>Trial still ongoing</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Eyeberu, Addis, Getachew, Tamirat, Amare, Getachew
|
|
et al. (2022) Use of tranexamic acid in decreasing blood loss during and after delivery among women in Africa: a systematic review and meta-analysis. Archives of gynecology and obstetrics [<a href="https://pubmed.ncbi.nlm.nih.gov/36436014" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 36436014</span></a>]
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Systematic review</p>
|
|
<p>Relevant studies have already been included in this review</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Fahrenholtz, Charles G.; Bonanno, Laura S.; Martin, Jennifer B. (2019) Tranexamic acid as adjuvant treatment for postpartum hemorrhage: a systematic review protocol. JBI database of systematic reviews and implementation reports
|
|
17(8): 1565–1572 [<a href="https://pubmed.ncbi.nlm.nih.gov/31404048" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31404048</span></a>]
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Protocol for a systematic review only</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Ferrari, Filippo Alberto, Garzon, Simone, Raffaelli, Ricciarda
|
|
et al. (2022) Tranexamic acid for the prevention and the treatment of primary postpartum haemorrhage: a systematic review. Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology: 1–13 [<a href="https://pubmed.ncbi.nlm.nih.gov/34996342" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 34996342</span></a>]
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Intervention</p>
|
|
<p>Systematic review where most of the included studies are looking at the prevention of PPH. Two of the included studies looking at treatment of PPH are already included under a Cochrane systematic review</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Ferrer, Pili, Roberts, Ian, Sydenham, Emma
|
|
et al. (2009) Anti-fibrinolytic agents in post partum haemorrhage: a systematic review. BMC pregnancy and childbirth
|
|
9: 29 [<a href="/pmc/articles/PMC2727491/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC2727491</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/19604358" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19604358</span></a>]
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Population not in PICO</p>
|
|
<p>Systematic review, references checked but not women with postpartum haemorrhage</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Gulmezoglu, M., Alfirevic, Z., Elbourne, D.
|
|
et al. (2009) Tranexamic acid for the treatment of postpartum haemorrhage: An international, randomised, double blind, placebo controlled trial (woman trial - Protocol Number ISRCTN76912190). International Journal of Gynecology and Obstetrics
|
|
107(suppl2): 500 [<a href="/pmc/articles/PMC2864262/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC2864262</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/20398351" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20398351</span></a>]
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Trial protocol only</p>
|
|
<p>Full published results included WOMAN trial</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Henry, Jaime and McFarland, Allison (2015) The effectiveness of tranexamic acid at reducing postoperative blood loss following cesarean section: A systematic review of quantitative evidence protocol. JBI Library of Systematic Reviews
|
|
13(6): 72–81 [<a href="https://pubmed.ncbi.nlm.nih.gov/26455746" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26455746</span></a>]
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Protocol for a systematic review only</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Hofmeyr, G. Justas, Maholwana, Babalwa, Walraven, Gijs
|
|
et al. (2005) Misoprostol to treat postpartum haemorrhage: A systematic review. BJOG: An International Journal of Obstetrics and Gynaecology
|
|
112(5): 547–553 [<a href="https://pubmed.ncbi.nlm.nih.gov/15842275" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15842275</span></a>]
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Systematic review - more recent systematic review available</p>
|
|
<p>A more recent Cochrane Systematic review with the same included studies has been included (<a class="bibr" href="#niceng235er15.s1.ref12" rid="niceng235er15.s1.ref12">Mousa 2014</a>)</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Hofmeyr, G. Justus, Gulmezoglu, A. Metin, Novikova, Natalia
|
|
et al. (2009) Misoprostol to prevent and treat postpartum haemorrhage: a systematic review and meta-analysis of maternal deaths and dose-related effects. Bulletin of the World Health Organization
|
|
87(9): 666–77 [<a href="/pmc/articles/PMC2739911/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC2739911</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/19784446" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19784446</span></a>]
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Intervention</p>
|
|
<p>Majority of included studies do not meet the PICO as focused on the prevention of PPH. 3 studies which do meet the PICO have already been included</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Hough, A., Koukounari, A., Shakur-Still, H.
|
|
et al. (2019) Stillbirths and neonatal deaths among women with postpartum haemorrhage: An analysis of rates and risks in the WOMAN trial. BJOG: An International Journal of Obstetrics and Gynaecology
|
|
126(supplement2): 69 [<a href="https://pubmed.ncbi.nlm.nih.gov/33029792" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33029792</span></a>]
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Outcomes not in PICO</p>
|
|
<p>Secondary data analysis from the WOMAN trial. The outcomes reported here are not listed in the PICO. Maternal death is reported here and listed in the PICO but has been reported in the main results of the WOMAN trial which has been included</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Huang, Xiaojuan, Xue, Wanxing, Zhou, Jin
|
|
et al. (2022) Effect of Carbetocin on Postpartum Hemorrhage after Vaginal Delivery: A Meta-Analysis. Computational and mathematical methods in medicine
|
|
2022: 6420738 [<a href="/pmc/articles/PMC9236811/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC9236811</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/35770122" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 35770122</span></a>]
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Intervention</p>
|
|
<p>Systematic review with included studies focused on the prevention of PPH and not the treatment of PPH</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Hunt, B. J. (2013) Tranexamic acid for the treatment of postpartum haemorrhage-preliminary results of the woman trial. Transfusion Medicine
|
|
23(suppl1): 7
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Conference abstract</p>
|
|
<p>Full results published in the WOMAN trial which has been included</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Igboke, Francis Nwabueze, Obi, Vitus Okwuchukwu, Dimejesi, Benedict Ikechukwu
|
|
et al. (2022) Tranexamic acid for reducing blood loss following vaginal delivery: a double-blind randomized controlled trial. BMC pregnancy and childbirth
|
|
22(1): 178 [<a href="/pmc/articles/PMC8896099/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC8896099</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/35241023" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 35241023</span></a>]
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Population not in PICO</p>
|
|
<p>Women do not have PPH. Study looking at the prevention of PPH and not the treatment of PPH</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Irct138812223548N (2010) The effect of misoprostrol in reduction of postpartum hemorrhage. <a href="http://www.who.int/trialsearch/Trial2.aspx?TrialID=IRCT138812223548N1" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">http://www<wbr style="display:inline-block"></wbr>​.who.int/trialsearch/Trial2<wbr style="display:inline-block"></wbr>​.aspx?TrialID<wbr style="display:inline-block"></wbr>​=IRCT138812223548N1</a>
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Trial protocol only</p>
|
|
<p>Full results located but not included as population not women with postpartum haemorrhage</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Irct20091023002624N (2017) Effect of tranexamic acid on postpartum hemorrhage. <a href="http://www.who.int/trialsearch/Trial2.aspx?TrialID=IRCT20091023002624N22" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">http://www<wbr style="display:inline-block"></wbr>​.who.int/trialsearch/Trial2<wbr style="display:inline-block"></wbr>​.aspx?TrialID<wbr style="display:inline-block"></wbr>​=IRCT20091023002624N22</a>
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Trial protocol only</p>
|
|
<p>Full results located but not included as population does not meet PICO as not women with postpartum haemorrhage</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Irct20120215009014N (2019) Comparison of the effect of extracts of the date, dill and grape seed versus placebo on postpartum hemorrhage in fourth stage of labor. <a href="http://www.who.int/trialsearch/Trial2.aspx?TrialID=IRCT20120215009014N300" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">http://www<wbr style="display:inline-block"></wbr>​.who.int/trialsearch/Trial2<wbr style="display:inline-block"></wbr>​.aspx?TrialID<wbr style="display:inline-block"></wbr>​=IRCT20120215009014N300</a>
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Trial protocol only</p>
|
|
<p>Published results not sought as intervention does not match PICO</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Irct2012122411862N (2013) Evaluation of effect of intra venuos Tranexamic acid and Misoprostol on Post Partum Hemorrhage and side effects of hemorrhage. <a href="http://www.who.int/trialsearch/Trial2.aspx?TrialID=IRCT2012122411862N1" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">http://www<wbr style="display:inline-block"></wbr>​.who.int/trialsearch/Trial2<wbr style="display:inline-block"></wbr>​.aspx?TrialID<wbr style="display:inline-block"></wbr>​=IRCT2012122411862N1</a>
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Trial protocol only</p>
|
|
<p>Published results included under <a class="bibr" href="#niceng235er15.s1.ref13" rid="niceng235er15.s1.ref13">Sahhaf 2014</a></p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Irct2013052613473N (2013) Tranexamic acid for treatment of postpartum hemorrhage. <a href="http://www.who.int/trialsearch/Trial2.aspx?TrialID=IRCT2013052613473N1" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">http://www<wbr style="display:inline-block"></wbr>​.who.int/trialsearch/Trial2<wbr style="display:inline-block"></wbr>​.aspx?TrialID<wbr style="display:inline-block"></wbr>​=IRCT2013052613473N1</a>
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Trial protocol only</p>
|
|
<p>Published results included under <a class="bibr" href="#niceng235er15.s1.ref8" rid="niceng235er15.s1.ref8">Javadi 2015</a></p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Irct2013080514275N (2014) Effect of misoprostol and oxytocin in controlling of hemorrhage after cesarean. <a href="http://www.who.int/trialsearch/Trial2.aspx?TrialID=IRCT2013080514275N1" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">http://www<wbr style="display:inline-block"></wbr>​.who.int/trialsearch/Trial2<wbr style="display:inline-block"></wbr>​.aspx?TrialID<wbr style="display:inline-block"></wbr>​=IRCT2013080514275N1</a>
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Trial protocol only</p>
|
|
<p>Published results located but not included as not women with post-partum haemorrhage</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Irct2017052029485N (2017) Effect of tranexamic acid on postpartum hemorrhage of natural delivery in Shariati hospital (2014-15). <a href="http://www.who.int/trialsearch/Trial2.aspx?TrialID=IRCT2017052029485N3" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">http://www<wbr style="display:inline-block"></wbr>​.who.int/trialsearch/Trial2<wbr style="display:inline-block"></wbr>​.aspx?TrialID<wbr style="display:inline-block"></wbr>​=IRCT2017052029485N3</a>
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Trial protocol only</p>
|
|
<p>Full results located but not included as population does not meet PICO as not women with postpartum haemorrhage</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Irct20180819040830N (2020) Tranexamic Acid for Decreasing the Blood Loss. <a href="http://www.who.int/trialsearch/Trial2.aspx?TrialID=IRCT20180819040830N2" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">http://www<wbr style="display:inline-block"></wbr>​.who.int/trialsearch/Trial2<wbr style="display:inline-block"></wbr>​.aspx?TrialID<wbr style="display:inline-block"></wbr>​=IRCT20180819040830N2</a>
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Trial protocol only</p>
|
|
<p>Published results not sought at population is not women with postpartum haemorrhage</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Isrctn (2013) Evaluation of intrauterine balloon tamponade efficacy with condom catheter in the severe postpartum hemorrhage management in Benin and Mali. <a href="http://www.who.int/trialsearch/Trial2.aspx?TrialID=ISRCTN01202389" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">http://www<wbr style="display:inline-block"></wbr>​.who.int/trialsearch/Trial2<wbr style="display:inline-block"></wbr>​.aspx?TrialID<wbr style="display:inline-block"></wbr>​=ISRCTN01202389</a>
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Trial protocol only</p>
|
|
<p>Published results located but not included as intervention does not meet PICO</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Isrctn (2018) The carboprost or oxytocin postpartum haemorrhage effectiveness study. <a href="http://www.who.int/trialsearch/Trial2.aspx?TrialID=ISRCTN16416766" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">http://www<wbr style="display:inline-block"></wbr>​.who.int/trialsearch/Trial2<wbr style="display:inline-block"></wbr>​.aspx?TrialID<wbr style="display:inline-block"></wbr>​=ISRCTN16416766</a>
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Trial protocol only</p>
|
|
<p>Trial still ongoing</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Jin, J. Z. (2015) The application effect of integrated medicine combined with nursing intervention on patients with postpartum hemorrhage. Chinese medicine modern distance education of china [zhong guo zhong yi yao xian dai yuan cheng jiao yu]
|
|
13(18): 77–78
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Trial protocol only</p>
|
|
<p>Published results not searched for as intervention does not meet PICO</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Kushtagi, P. and Verghese, L. M. (2006) Evaluation of two uterotonic medications for the management of the third stage of labor. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics
|
|
94(1): 47–8 [<a href="https://pubmed.ncbi.nlm.nih.gov/16762355" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 16762355</span></a>]
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Population not in PICO</p>
|
|
<p>Not women with post-partum haemorrhage</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Leas, B. and Umscheid, C. A. (2011) Active management and treatment of postpartum hemorrhage.
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study design</p>
|
|
<p>Review of systematic reviews. Studies checked but have already included more recent systematic reviews</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Leduc, Dean; Senikas, Vyta; Lalonde, Andre B. (2018) No. 235-Active Management of the Third Stage of Labour: Prevention and Treatment of Postpartum Hemorrhage. Journal of Obstetrics and Gynaecology Canada
|
|
40(12): e841–e855 [<a href="https://pubmed.ncbi.nlm.nih.gov/30527079" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30527079</span></a>]
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study design</p>
|
|
<p>Not a systematic review or randomised controlled trial</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Leduc, Dean, Senikas, Vyta, Lalonde, Andre B.
|
|
et al. (2009) Active management of the third stage of labour: prevention and treatment of postpartum hemorrhage. Journal of obstetrics and gynaecology Canada : JOGC = Journal d’obstetrique et gynecologie du Canada : JOGC
|
|
31(10): 980–993 [<a href="https://pubmed.ncbi.nlm.nih.gov/19941729" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19941729</span></a>]
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study design</p>
|
|
<p>Not a systematic review or a randomised controlled trial</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Li, B., Miners, A., Shakur, H.
|
|
et al. (2018) Tranexamic acid for treatment of women with post-partum haemorrhage in Nigeria and Pakistan: a cost-effectiveness analysis of data from the WOMAN trial. The lancet. Global health
|
|
6(2): e222–e228 [<a href="/pmc/articles/PMC5785366/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5785366</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/29389542" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29389542</span></a>]
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study design</p>
|
|
<p>Cost effectiveness analysis of the WOMAN trial which has been included in this review. Study considered for economics</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Li, X., Wang, H., Wang, J.
|
|
et al. (2002) Prophylactic and therapeutic effect of misoprofil plus oxytocin on postpartum hemorrhage in patients with pregnancy-induced hypertension syndrome. Journal of postgraduates of medicine
|
|
25(7): 34–35
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Full text not in English</p>
|
|
<p>Article in Chinese</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Likis, F. E., Sathe, N. A., Morgans, A. K.
|
|
et al. (2015) Management of postpartum hemorrhage. [<a href="https://pubmed.ncbi.nlm.nih.gov/26020092" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26020092</span></a>]
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Systematic review - more recent systematic review available</p>
|
|
<p>Only 1 of the included studies in this systematic review meets our PICO. This has been included in a more recent systematic review</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Mirzazada, S. (2012) Misoprostol for the treatment of PPH following its use for prevention (Afghanistan & Pakistan). International Journal of Gynecology and Obstetrics
|
|
119(suppl3): 223
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Conference abstract.</p>
|
|
<p>Conference abstract only, full text has been assessed under <a class="bibr" href="#niceng235er15.s1.ref1" rid="niceng235er15.s1.ref1">Abbas 2019</a> and <a class="bibr" href="#niceng235er15.s1.ref2" rid="niceng235er15.s1.ref2">2020</a></p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Moosivand, A., Foroughi Moghadam, M., Khedmati, J.
|
|
et al. (2016) Cost-utility analysis of carbetocin versus oxytocin for managing postpartum hemorrhage. Value in Health
|
|
19(3): a177
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Conference abstract</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Mousa, H. A., Blum, J., Abou El Senoun, G.
|
|
et al. (2013) Treatment for primary postpartum haemorrhage - A cochrane systematic review. Archives of Disease in Childhood: Fetal and Neonatal Edition
|
|
98(suppl1)
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Conference abstract</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Murphy, Deirdre J., MacGregor, Honor, Munishankar, Bhagya
|
|
et al. (2009) A randomised controlled trial of oxytocin 5IU and placebo infusion versus oxytocin 5IU and 30IU infusion for the control of blood loss at elective caesarean section-Pilot study. ISRCTN 40302163. European Journal of Obstetrics and Gynecology and Reproductive Biology
|
|
142(1): 30–33 [<a href="https://pubmed.ncbi.nlm.nih.gov/18977579" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 18977579</span></a>]
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Population not in PICO</p>
|
|
<p>Not women with post-partum haemorrhage</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Nandal, I., Kochar, S.P.S., Dahiya, A.
|
|
et al. (2022) Role of Intravenous Tranexamic Acid in Reducing Blood Loss during Caesarean Delivery. International Medical Journal
|
|
29(1): 23–25
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Intervention</p>
|
|
<p>Tranexamic acid given as part of prevention not for treatment of postpartum haemorrhage</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Nct (2018) Misoprostol Before and After Cesarean Section. <a href="https://clinicaltrials.gov/show/NCT03463070" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://clinicaltrials.gov/show/NCT03463070</a>
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Trial protocol only</p>
|
|
<p>Results have not been posted</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Nct (2019) Oral Tranexamic Acid Plus Sublingual Misoprostol in Atonic Postpartum Hemorrhage. <a href="https://clinicaltrials.gov/show/NCT03870256" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://clinicaltrials.gov/show/NCT03870256</a>
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Trial protocol only</p>
|
|
<p>Full results not published</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Nct (2014) Ergometrine Versus Oxytocin in the Management of Atonic Post-partum Haemorrhage (PPH) in Women Delivered Vaginally. <a href="https://clinicaltrials.gov/show/NCT02306733" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://clinicaltrials.gov/show/NCT02306733</a>
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Trial protocol only</p>
|
|
<p>Full results not published</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Nct (2014) Carbetocin Versus Oxytocin in the Management of Atonic Post Partum Haemorrhage (PPH) in Women Delivered Vaginally: a Randomised Controlled Trial. <a href="https://clinicaltrials.gov/show/NCT02304055" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://clinicaltrials.gov/show/NCT02304055</a> [<a href="https://pubmed.ncbi.nlm.nih.gov/26511939" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26511939</span></a>]
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Trial protocol only</p>
|
|
<p>Results published under <a class="bibr" href="#niceng235er15.s1.ref11" rid="niceng235er15.s1.ref11">Maged 2016</a></p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Nct (2009) Tranexamic Acid for the Treatment of Postpartum Haemorrhage: an International Randomised, Double Blind, Placebo Controlled Trial. <a href="http://clinicaltrials.gov/show/nct00872469" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Http:<wbr style="display:inline-block"></wbr>​//clinicaltrials<wbr style="display:inline-block"></wbr>​.gov/show/nct00872469</a> [<a href="/pmc/articles/PMC2864262/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC2864262</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/20398351" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20398351</span></a>]
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Trial protocol only</p>
|
|
<p>Full results located and included (WOMAN trial)</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Nct (2011) Misoprostol for Treatment of Postpartum Haemorrhage (PPH) in Home Births. <a href="https://clinicaltrials.gov/show/NCT01508429" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://clinicaltrials.gov/show/NCT01508429</a>
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Trial protocol only</p>
|
|
<p>For decision on full published results see <a class="bibr" href="#niceng235er15.s1.ref2" rid="niceng235er15.s1.ref2">Abbas 2020</a></p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Nct (2011) Treatment of Postpartum Haemorrhage (PPH) Using Misoprostol in Home Births. <a href="https://clinicaltrials.gov/show/NCT01485562" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://clinicaltrials.gov/show/NCT01485562</a>
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Trial protocol only</p>
|
|
<p>For decision on published results see <a class="bibr" href="#niceng235er15.s1.ref1" rid="niceng235er15.s1.ref1">Abbas 2019</a></p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Nct (2019) Carbetocin Versus Oxytocin Plus Sublingual Misoprostol in the Management of Atonic Postpartum Hemorrhage. <a href="https://clinicaltrials.gov/show/NCT03870503" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://clinicaltrials.gov/show/NCT03870503</a>
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Trial protocol only</p>
|
|
<p>Published results not located</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Nct (2014) Fibrinogen in Haemorrhage of Delivery. <a href="https://clinicaltrials.gov/show/NCT02155725" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://clinicaltrials.gov/show/NCT02155725</a>
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Trial protocol only</p>
|
|
<p>Published results located but not included as intervention does not meet PICO</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Nct (2005) Misoprostol in the Treatment of Postpartum Hemorrhage. <a href="https://clinicaltrials.gov/show/NCT00116480" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://clinicaltrials.gov/show/NCT00116480</a>
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Trial protocol only</p>
|
|
<p>Published results included under <a class="bibr" href="#niceng235er15.s1.ref21" rid="niceng235er15.s1.ref21">Zuberi 2008</a></p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Nct (2015) Carbetocin Versus Ergometrine in the Management of Atonic Post Partum Haemorrhage (PPH) in Women Delivered Vaginally. <a href="https://clinicaltrials.gov/show/NCT02410759" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://clinicaltrials.gov/show/NCT02410759</a>
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Trial protocol only</p>
|
|
<p>Published results not located</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Nct (2005) Misoprostol for the Treatment of Postpartum Hemorrhage. <a href="https://clinicaltrials.gov/show/NCT00116350" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://clinicaltrials.gov/show/NCT00116350</a>
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Trial protocol only</p>
|
|
<p>Published results included, <a class="bibr" href="#niceng235er15.s1.ref3" rid="niceng235er15.s1.ref3">Blum 2010</a> and <a class="bibr" href="#niceng235er15.s1.ref19" rid="niceng235er15.s1.ref19">Winikoff 2010</a></p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Nct (2016) Effectiveness of Tranexamic Acid When Used as an Adjunct to Misoprostol for the Treatment of Postpartum Hemorrhage. <a href="https://clinicaltrials.gov/show/NCT02805426" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://clinicaltrials.gov/show/NCT02805426</a>
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Trial protocol only</p>
|
|
<p>Published results included under <a class="bibr" href="#niceng235er15.s1.ref5" rid="niceng235er15.s1.ref5">Diop 2020</a></p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Nct (2009) World Maternal Antifibrinolytic Trial. <a href="https://clinicaltrials.gov/show/NCT00872469" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://clinicaltrials.gov/show/NCT00872469</a>
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Trial protocol only</p>
|
|
<p>Published results included WOMAN trial</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Nct (2010) Intrarectal Misoprostol in Postpartum Haemorrhage. <a href="https://clinicaltrials.gov/show/NCT01116050" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://clinicaltrials.gov/show/NCT01116050</a>
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Trial protocol only</p>
|
|
<p>Published results not located</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Nct (2016) Tranexamic Acid to Reduce Blood Loss in Hemorrhagic Caesarean Delivery. <a href="https://clinicaltrials.gov/show/NCT02797119" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://clinicaltrials.gov/show/NCT02797119</a>
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Trial protocol only</p>
|
|
<p>Trial still ongoing</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Nct (2016) IV Versus IM Administration of Oxytocin for Postpartum Bleeding. <a href="https://clinicaltrials.gov/show/NCT02954068" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://clinicaltrials.gov/show/NCT02954068</a>
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Trial protocol only</p>
|
|
<p>Published results not searched for as population not women with postpartum haemorrhage</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Nct (2012) Misoprostol for Treatment of Postpartum Hemorrhage at Community-level Births in Egypt. <a href="https://clinicaltrials.gov/show/NCT01619072" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://clinicaltrials.gov/show/NCT01619072</a>
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Trial protocol only</p>
|
|
<p>Published results not located</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Nct (2018) Sublingual Misoprostol With or Without Intravenous Tranexamic Acid During Hemorrhagic Cesarean Section. <a href="https://clinicaltrials.gov/show/NCT03774706" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://clinicaltrials.gov/show/NCT03774706</a>
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Trial protocol only</p>
|
|
<p>Trial still ongoing</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Nct (2012) Oxytocin, Carbetocin and Misopristol for Treatment of Postpartum Hemorrhage: a Multicentric Randomized Trial. <a href="https://clinicaltrials.gov/show/NCT01600612" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://clinicaltrials.gov/show/NCT01600612</a>
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Trial protocol only</p>
|
|
<p>Published results not located</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Nct (2018) Second-Line Uterotonics in Postpartum Hemorrhage: a Randomized Clinical Trial. <a href="https://clinicaltrials.gov/show/NCT03584854" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://clinicaltrials.gov/show/NCT03584854</a>
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Trial protocol only</p>
|
|
<p>Trial is still ongoing</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Nct (2015) Carbetocin Versus Oxytocin in Caesarean Section for the Control of Postpartum Haemorrhage. <a href="https://clinicaltrials.gov/show/NCT02396303" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://clinicaltrials.gov/show/NCT02396303</a>
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Trial protocol only</p>
|
|
<p>Published results not located</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Okonofua, Friday Ebhodaghe, Ogu, Rosemary Nkemdilim, Akuse, James Terkura
|
|
et al. (2014) Assessment of sublingual misoprostol as first-line treatment for primary post-partum hemorrhage: results of a multicenter trial. The journal of obstetrics and gynaecology research
|
|
40(3): 718–22 [<a href="https://pubmed.ncbi.nlm.nih.gov/24320203" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24320203</span></a>]
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study design</p>
|
|
<p>Not a randomised controlled trial</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Oladapo, Olufemi T., Blum, Jennifer, Abalos, Edgardo
|
|
et al. (2020) Advance misoprostol distribution to pregnant women for preventing and treating postpartum haemorrhage. Cochrane Database of Systematic Reviews
|
|
2020(6): cd009336 [<a href="/pmc/articles/PMC7390441/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7390441</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/35819305" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 35819305</span></a>]
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Intervention</p>
|
|
<p>Systematic review where included studies do not meet the PICO as intervention is for prophylaxis of post-partum haemorrhage</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Olefile, Kabelo M.; Khondowe, Oswell; M’Rithaa, Doreen (2013) Misoprostol for prevention and treatment of postpartum haemorrhage: A systematic review. Curationis
|
|
36(1): E1–10 [<a href="https://pubmed.ncbi.nlm.nih.gov/23718882" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23718882</span></a>]
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Population not in PICO</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Olufowobi, O., Afnan, M., Sorinola, O.
|
|
et al. (2002) A randomized study comparing rectally administered misoprostol versus syntometrine combined with an oxytocin infusion for the cessation of primary postpartum hemorrhage. Acta obstetricia et gynecologica Scandinavica
|
|
81(10) [<a href="https://pubmed.ncbi.nlm.nih.gov/12366496" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 12366496</span></a>]
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study design</p>
|
|
<p>Letter regarding a randomised controlled trial already included (<a class="bibr" href="#niceng235er15.s1.ref10" rid="niceng235er15.s1.ref10">Lokugamage 2001</a>)</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Pactr (2020) Tranexamic acid for reducing blood loss following vaginal delivery. <a href="http://www.who.int/trialsearch/Trial2.aspx?TrialID=PACTR202010828881019" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">http://www<wbr style="display:inline-block"></wbr>​.who.int/trialsearch/Trial2<wbr style="display:inline-block"></wbr>​.aspx?TrialID<wbr style="display:inline-block"></wbr>​=PACTR202010828881019</a>
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Trial protocol only</p>
|
|
<p>Full results not found, but population is not women with postpartum haemorrhage</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Pactr (2020) EFFECT OF TRANEXAMIC ACID ON PRIMARY POSTPARTUM HAEMORRHAGE IN AT – RISK WOMEN AT ABUTH, ZARIA: a RANDOMIZED CONTROLLED STUDY. <a href="http://www.who.int/trialsearch/Trial2.aspx?TrialID=PACTR202004568331645" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">http://www<wbr style="display:inline-block"></wbr>​.who.int/trialsearch/Trial2<wbr style="display:inline-block"></wbr>​.aspx?TrialID<wbr style="display:inline-block"></wbr>​=PACTR202004568331645</a>
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Trial protocol only</p>
|
|
<p>Published results not located</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Parry Smith, William R., Papadopoulou, Argyro, Thomas, Eleanor
|
|
et al. (2020) Uterotonic agents for first-line treatment of postpartum haemorrhage: a network meta-analysis. Cochrane Database of Systematic Reviews
|
|
2020(11): cd012754 [<a href="/pmc/articles/PMC8130992/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC8130992</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/33232518" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33232518</span></a>]
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study design</p>
|
|
<p>Network Meta-analysis - references checked and studies relevant to PICO have been included</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Peitsidis, Panagiotis and Kadir, Rezan A. (2011) Antifibrinolytic therapy with tranexamic acid in pregnancy and postpartum. Expert opinion on pharmacotherapy
|
|
12(4): 503–16 [<a href="https://pubmed.ncbi.nlm.nih.gov/21294602" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21294602</span></a>]
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Systematic review - more recent systematic review available</p>
|
|
<p>References checked and 1 study is of relevance, but has been included as part of a more recently published systematic review (<a class="bibr" href="#niceng235er15.s1.ref6" rid="niceng235er15.s1.ref6">Ducloy-Bouthors 2011</a>)</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Prata, N., Mbaruku, G., Campbell, M.
|
|
et al. (2005) Controlling postpartum hemorrhage after home births in Tanzania. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics
|
|
90(1): 51–5 [<a href="https://pubmed.ncbi.nlm.nih.gov/15919088" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15919088</span></a>]
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study design</p>
|
|
<p>Not a randomised controlled trial</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Rangel, Rita de Cassia Teixeira, Souza, Maria de Lourdes de, Bentes, Cheila Maria Lins
|
|
et al. (2019) Care technologies to prevent and control hemorrhage in the third stage of labor: a systematic review. Tecnologias de cuidado para prevencao e controle da hemorragia no terceiro estagio do parto: revisao sistematica. 27: e3165 [<a href="/pmc/articles/PMC6703106/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6703106</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/31432919" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31432919</span></a>]
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Systematic review - more recent systematic review available</p>
|
|
<p>A more recent Cochrane review with the relevant included studies from this systemtatic review has been included</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Sentilhes, L., Lasocki, S., Ducloy-Bouthors, A. S.
|
|
et al. (2015) Tranexamic acid for the prevention and treatment of postpartum haemorrhage. British journal of anaesthesia
|
|
114(4): 576–87 [<a href="https://pubmed.ncbi.nlm.nih.gov/25571934" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25571934</span></a>]
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Systematic review - more recent systematic review available</p>
|
|
<p>One included study matching the PICO which has been included as part of a more recent systematic review</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Shaheen, Nighat and Khalil, Safia (2019) Safety and efficacy of 600ug sublingual misoprostol versus 10 U intramuscular Oxytocin for management of third stage of labor. Rawal Medical Journal
|
|
44(1): 137–140
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Population not in PICO</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Shakur, H., Elbourne, D., Gülmezoglu, M.
|
|
et al. (2010) The WOMAN Trial (World Maternal Antifibrinolytic Trial): tranexamic acid for the treatment of postpartum haemorrhage: an international randomised, double blind placebo controlled trial. Trials
|
|
11: 40 [<a href="/pmc/articles/PMC2864262/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC2864262</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/20398351" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20398351</span></a>]
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Trial protocol only</p>
|
|
<p>Full results have been included</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Shakur, Haleema, Roberts, Ian, Edwards, Philip
|
|
et al. (2016) The effect of tranexamic acid on the risk of death and hysterectomy in women with post-partum haemorrhage: statistical analysis plan for the WOMAN trial. Trials
|
|
17(1): 249 [<a href="/pmc/articles/PMC4869395/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4869395</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/27188698" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27188698</span></a>]
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Statistical analysis plan only</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Sheldon, Wendy R., Blum, Jennifer, Durocher, Jill
|
|
et al. (2012) Misoprostol for the prevention and treatment of postpartum hemorrhage. Expert opinion on investigational drugs
|
|
21(2): 235–50 [<a href="https://pubmed.ncbi.nlm.nih.gov/22233426" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22233426</span></a>]
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study design</p>
|
|
<p>Not a systematic review (literature review)</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Slctr (2011) Anticipatory management vs standard management of postpartum haemorrhage. <a href="http://www.who.int/trialsearch/Trial2.aspx?TrialID=SLCTR/2011/010" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">http://www<wbr style="display:inline-block"></wbr>​.who.int/trialsearch/Trial2<wbr style="display:inline-block"></wbr>​.aspx?TrialID=SLCTR<wbr style="display:inline-block"></wbr>​/2011/010</a>
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Trial protocol only</p>
|
|
<p>Published results not located</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Suhrabi, Zainab, Akbari, Malihe, Taghinejad, Hamid
|
|
et al. (2019) Comparing the effect of dextrose and oxytocin to reduce postpartum haemorrhage: Randomised controlled trial. Journal of Clinical and Diagnostic Research
|
|
13(7): QC09–QC11 [<a href="/pmc/articles/PMC5072022/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5072022</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/27790522" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27790522</span></a>]
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Population not in PICO</p>
|
|
<p>Not women with post-partum haemorrhage</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Takagi, S., Yoshida, T., Togo, Y.
|
|
et al. (1976) The effects of intramyometrial injection of prostaglandin F2alpha on severe post-partum hemorrhage. Prostaglandins
|
|
12(4): 565–579 [<a href="https://pubmed.ncbi.nlm.nih.gov/1085940" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 1085940</span></a>]
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Population not in PICO</p>
|
|
<p>Post-partum haemorrhage not as defined in the PICO</p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Widmer, Mariana, Blum, Jennifer, Hofmeyr, G. Justus
|
|
et al. (2010) Misoprostol as an adjunct to standard uterotonics for treatment of postpartum hemorrhage: A multicentre, double-blind randomized trial. Obstetrical and Gynecological Survey
|
|
65(10): 609–610
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Study design</p>
|
|
<p>Editorial comment only. Actual trial included separately under <a class="bibr" href="#niceng235er15.s1.ref18" rid="niceng235er15.s1.ref18">Widmer 2010</a></p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Widmer, Mariana, Blum, Jennifer, Hofmeyr, G. Justus
|
|
et al. (2010) Misoprostol as an adjunct to standard uterotonics for treatment of post-partum haemorrhage: a multicentre, double-blind randomised trial. Lancet (London, England)
|
|
375(9728): 1808–13 [<a href="https://pubmed.ncbi.nlm.nih.gov/20494730" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20494730</span></a>]
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Included as part of a systematic review</p>
|
|
<p>Included in Cochrane review <a class="bibr" href="#niceng235er15.s1.ref12" rid="niceng235er15.s1.ref12">Mousa 2014</a></p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Winikoff, B., Dabash, R., Durocher, J.
|
|
et al. (2009) Treatment of postpartum hemorrhage with sublingual misoprostol versus oxytocin: Results from a randomized, non-inferiority trial among women not exposed to oxytocin during labor. International Journal of Gynecology and Obstetrics
|
|
107(suppl2): 59
|
|
</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>- Conference abstract</p>
|
|
<p>Full results included under <a class="bibr" href="#niceng235er15.s1.ref19" rid="niceng235er15.s1.ref19">Winikoff 2010</a></p>
|
|
</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Zhou, M., Yang, C. Y., Zhao, Y.
|
|
et al. (2006) Clinical value of adjuvant therapy with estrogen for postpartum hemorrhage. Nan fang yi ke da xue xue bao [Journal of Southern Medical University]
|
|
26(6): 865–866 [<a href="https://pubmed.ncbi.nlm.nih.gov/16793623" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 16793623</span></a>]
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</td><td headers="hd_h_niceng235er15.appj.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>- Full text not in English</p>
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<p>Article in Chinese</p>
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</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng235er15appjtab2"><div id="niceng235er15.appj.tab2" class="table"><h3><span class="label">Table 17</span><span class="title">Excluded studies and reasons for their exclusion</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK596278/table/niceng235er15.appj.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng235er15.appj.tab2_lrgtbl__"><table><thead><tr><th id="hd_h_niceng235er15.appj.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th id="hd_h_niceng235er15.appj.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Reason</th></tr></thead><tbody><tr><td headers="hd_h_niceng235er15.appj.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Aziz, Samia, Rossiter, Shania, Homer, Caroline S. E.
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et al. (2021) The cost-effectiveness of tranexamic acid for treatment of postpartum hemorrhage: A systematic review. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics [<a href="/pmc/articles/PMC8596845/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC8596845</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/33621351" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33621351</span></a>]
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</td><td headers="hd_h_niceng235er15.appj.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Review article</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Bandara, S.; Angala, P.; Haloob, R. (2017) Carbitocin: A cost-effective tool to save lives!. BJOG: An International Journal of Obstetrics and Gynaecology
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124(supplement1): 27
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</td><td headers="hd_h_niceng235er15.appj.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Prevention not management</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Gallos, Ioannis, Williams, Helen, Merriel, Abi
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et al. (2019) Uterotonic drugs to prevent postpartum haemorrhage: A network meta-analysis. Health Technology Assessment
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23(9): 1–356 [<a href="/pmc/articles/PMC6421507/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6421507</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/30821683" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30821683</span></a>]
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</td><td headers="hd_h_niceng235er15.appj.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Prevention not management</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Howard, Dagnie, Skeith, Ashley E., Lai, Jasmine
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et al. (2018) Routine use of tranexamic acid in postpartum hemorrhage: A cost-effectiveness analysis. Obstetrics and Gynecology
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131(supplement1): 171S–172S [<a href="https://pubmed.ncbi.nlm.nih.gov/35124299" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 35124299</span></a>]
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</td><td headers="hd_h_niceng235er15.appj.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Conference abstract</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Lawrie, Theresa A., Rogozinska, Ewelina, Sobiesuo, Pauline
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et al. (2019) A systematic review of the cost-effectiveness of uterotonic agents for the prevention of postpartum hemorrhage. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics
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146(1): 56–64 [<a href="https://pubmed.ncbi.nlm.nih.gov/31049950" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31049950</span></a>]
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</td><td headers="hd_h_niceng235er15.appj.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Prevention not management</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Luni, Yasmin, Borakati, Aditya, Matah, Arti
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et al. (2017) A prospective cohort study evaluating the cost-effectiveness of carbetocin for prevention of postpartum haemorrhage in caesarean sections. Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology
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37(5): 601–604 [<a href="https://pubmed.ncbi.nlm.nih.gov/28317421" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28317421</span></a>]
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</td><td headers="hd_h_niceng235er15.appj.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Prevention not management</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Moosivand, A., Foroughi Moghadam, M., Khedmati, J.
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et al. (2016) Cost-utility analysis of carbetocin versus oxytocin for managing postpartum hemorrhage. Value in Health
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19(3): a177
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</td><td headers="hd_h_niceng235er15.appj.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Conference abstract</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Morris, C., Siassakos, D., Draycott, T. J.
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et al. (2013) Cost comparison of routine carbetocin use at caesarean section. BJOG: An International Journal of Obstetrics and Gynaecology
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120(suppl1): 119–120
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</td><td headers="hd_h_niceng235er15.appj.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Prevention not management</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Patel, B. and Haloob, R. (2014) Carbitocin: A cost-effective tool to save lives. BJOG: An International Journal of Obstetrics and Gynaecology
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121(suppl2): 88–89
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</td><td headers="hd_h_niceng235er15.appj.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Prevention not management</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Pickering, Karen, Gallos, Ioannis D., Williams, Helen
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et al. (2019) Uterotonic Drugs for the Prevention of Postpartum Haemorrhage: A Cost-Effectiveness Analysis. PharmacoEconomics - open
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3(2): 163–176 [<a href="/pmc/articles/PMC6533349/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6533349</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/30506157" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30506157</span></a>]
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</td><td headers="hd_h_niceng235er15.appj.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Prevention not management</td></tr><tr><td headers="hd_h_niceng235er15.appj.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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van der Nelson, Helen A., Draycott, Tim, Siassakos, Dimitrios
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et al. (2017) Carbetocin versus oxytocin for prevention of post-partum haemorrhage at caesarean section in the United Kingdom: An economic impact analysis. European journal of obstetrics, gynecology, and reproductive biology
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210: 286–291 [<a href="https://pubmed.ncbi.nlm.nih.gov/28088109" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28088109</span></a>]
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</td><td headers="hd_h_niceng235er15.appj.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Prevention not management</td></tr></tbody></table></div></div></article></div><div id="jr-scripts"><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/libs.min.js"> </script><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.min.js"> </script></div></div>
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