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Cochrane Database of Systematic Reviews

正期産の骨盤位妊娠に対する選択的帝王切開術

Información

DOI:
https://doi.org/10.1002/14651858.CD000166.pub2Copiar DOI
Base de datos:
  1. Cochrane Database of Systematic Reviews
Versión publicada:
  1. 21 julio 2015see what's new
Tipo:
  1. Intervention
Etapa:
  1. Review
Grupo Editorial Cochrane:
  1. Grupo Cochrane de Embarazo y parto

Copyright:
  1. Copyright © 2019 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

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Autores

  • G Justus Hofmeyr

    Correspondencia a: Walter Sisulu University, University of Fort Hare, University of the Witwatersrand, Eastern Cape Department of Health, East London, South Africa

    [email protected]

  • Mary Hannah

    Department of Obstetrics and Gynaecology, University of Toronto, Toronto, Canada

  • Theresa A Lawrie

    Evidence‐Based Medicine Consultancy, Bath, UK

Contributions of authors

GJ Hofmeyr and ME Hannah prepared the first version of the review together. Justus Hofmeyr prepared the 2011 update with assistance from Tess Lawrie, and Mary Hannah approved it. Tess Lawrie assisted with study selection, data extraction, updating the 'Risk of bias' tables and editing the review. GJ Hofmeyr is responsible for maintaining the review and prepared the 2015 update.

Sources of support

Internal sources

  • University of the Witwatersrand, South Africa.

  • University of Toronto Maternal, Infant and Reproductive Health Research Unit, Canada.

  • (HW) Cochrane Pregnancy and Childbirth Group, Department of Women's and Children's Health, The University of Liverpool, Liverpool, UK.

External sources

  • South African Medical Research Council, South Africa.

  • The Nuffield Trust, UK.

  • HRP ‐ UNDP/UNFPA/WHO/World Bank Special Programme in Human Reproduction, Geneva, Switzerland.

  • (GJH) Rockefeller Foundation Residency, Oct 2004, USA.

  • (HW) National Institute for Health Research (NIHR), UKNIHR Cochrane Programme Grant Project: 13/89/05 – Pregnancy and childbirth systematic reviews to support clinical guidelines, UK.

Declarations of interest

Mary Hannah is principal investigator and Justus Hofmeyr a collaborator of the Term Breech Trial (Hannah 2000), which is included in this review. Tess Lawrie undertook assessment and data extraction for this trial. Justus Hofmeyr receives royalties from UpToDate for chapters related to breech pregnancy, delivery of a baby in breech presentation and external cephalic version. UpToDate is an electronic publication by Wolters Kluwer to disseminate evidence‐based medicine (such as Cochrane reviews).

Acknowledgements

Denise Atherton for administrative assistance; Lynn Hampson for the literature search; Helen West for assistance with the 2015 revision.

This project was supported by the National Institute for Health Research, via Cochrane programme Grant funding to Cochrane Pregnancy and Childbirth. The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the Systematic Reviews Programme, NIHR, NHS or the Department of Health.

Version history

Published

Title

Stage

Authors

Version

2015 Jul 21

Planned caesarean section for term breech delivery

Review

G Justus Hofmeyr, Mary Hannah, Theresa A Lawrie

https://doi.org/10.1002/14651858.CD000166.pub2

2001 Jan 22

Planned caesarean section for term breech delivery

Review

G Justus Hofmeyr, Mary Hannah, Theresa A Lawrie

https://doi.org/10.1002/14651858.CD000166

Differences between protocol and review

Methods updated to current Pregnancy and Childbirth Group standard text. A summary of findings table has been incorporated for the 2015 update.

The list of outcome measures was developed in 2000 as a generic list for reviews of planned caesarean section for various indications. The list was revised in 2003 and 2004 to include additional measures of neonatal and maternal morbidity (marked * and ** respectively) within "Types of outcomes".

Subgroup analysis was performed for countries with low (20 or less per 1000) and high (more than 20 per 1000) national perinatal mortality rates, as defined in the Term Breech Trial (Hannah 2000). This analysis was not specified in the original review protocol.

Keywords

MeSH

PICO

Population
Intervention
Comparison
Outcome

El uso y la enseñanza del modelo PICO están muy extendidos en el ámbito de la atención sanitaria basada en la evidencia para formular preguntas y estrategias de búsqueda y para caracterizar estudios o metanálisis clínicos. PICO son las siglas en inglés de cuatro posibles componentes de una pregunta de investigación: paciente, población o problema; intervención; comparación; desenlace (outcome).

Para saber más sobre el uso del modelo PICO, puede consultar el Manual Cochrane.

'Risk of bias. graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
Figuras y tablas -
Figure 1

'Risk of bias. graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.

.Risk of bias. summary: review authors' judgements about each risk of bias item for each included study.
Figuras y tablas -
Figure 2

.Risk of bias. summary: review authors' judgements about each risk of bias item for each included study.

Comparison 1 Planned caesarean section for term breech presentation, Outcome 1 Perinatal/neonatal death or severe neonatal morbidity.
Figuras y tablas -
Analysis 1.1

Comparison 1 Planned caesarean section for term breech presentation, Outcome 1 Perinatal/neonatal death or severe neonatal morbidity.

Comparison 1 Planned caesarean section for term breech presentation, Outcome 2 Death or neurodevelopmental delay at age 2 years.
Figuras y tablas -
Analysis 1.2

Comparison 1 Planned caesarean section for term breech presentation, Outcome 2 Death or neurodevelopmental delay at age 2 years.

Comparison 1 Planned caesarean section for term breech presentation, Outcome 3 Perinatal/neonatal mortality (excluding fatal malformations).
Figuras y tablas -
Analysis 1.3

Comparison 1 Planned caesarean section for term breech presentation, Outcome 3 Perinatal/neonatal mortality (excluding fatal malformations).

Comparison 1 Planned caesarean section for term breech presentation, Outcome 4 5 minute Apgar < 7.
Figuras y tablas -
Analysis 1.4

Comparison 1 Planned caesarean section for term breech presentation, Outcome 4 5 minute Apgar < 7.

Comparison 1 Planned caesarean section for term breech presentation, Outcome 5 5 minute Apgar < 4.
Figuras y tablas -
Analysis 1.5

Comparison 1 Planned caesarean section for term breech presentation, Outcome 5 5 minute Apgar < 4.

Comparison 1 Planned caesarean section for term breech presentation, Outcome 6 Cord blood pH < 7.0.
Figuras y tablas -
Analysis 1.6

Comparison 1 Planned caesarean section for term breech presentation, Outcome 6 Cord blood pH < 7.0.

Comparison 1 Planned caesarean section for term breech presentation, Outcome 7 Cord blood base deficit =/> 15.
Figuras y tablas -
Analysis 1.7

Comparison 1 Planned caesarean section for term breech presentation, Outcome 7 Cord blood base deficit =/> 15.

Comparison 1 Planned caesarean section for term breech presentation, Outcome 8 Birth trauma, as defined by trial authors.
Figuras y tablas -
Analysis 1.8

Comparison 1 Planned caesarean section for term breech presentation, Outcome 8 Birth trauma, as defined by trial authors.

Comparison 1 Planned caesarean section for term breech presentation, Outcome 9 Brachial plexus injury.
Figuras y tablas -
Analysis 1.9

Comparison 1 Planned caesarean section for term breech presentation, Outcome 9 Brachial plexus injury.

Comparison 1 Planned caesarean section for term breech presentation, Outcome 10 Infant medical problems at 2 years.
Figuras y tablas -
Analysis 1.10

Comparison 1 Planned caesarean section for term breech presentation, Outcome 10 Infant medical problems at 2 years.

Comparison 1 Planned caesarean section for term breech presentation, Outcome 11 Neurodevelopmental delay at age 2 years.
Figuras y tablas -
Analysis 1.11

Comparison 1 Planned caesarean section for term breech presentation, Outcome 11 Neurodevelopmental delay at age 2 years.

Comparison 1 Planned caesarean section for term breech presentation, Outcome 12 Caesarean section.
Figuras y tablas -
Analysis 1.12

Comparison 1 Planned caesarean section for term breech presentation, Outcome 12 Caesarean section.

Comparison 1 Planned caesarean section for term breech presentation, Outcome 13 Short‐term maternal morbidity.
Figuras y tablas -
Analysis 1.13

Comparison 1 Planned caesarean section for term breech presentation, Outcome 13 Short‐term maternal morbidity.

Comparison 1 Planned caesarean section for term breech presentation, Outcome 14 Woman not satisfied.
Figuras y tablas -
Analysis 1.14

Comparison 1 Planned caesarean section for term breech presentation, Outcome 14 Woman not satisfied.

Comparison 1 Planned caesarean section for term breech presentation, Outcome 15 Postnatal depression at 3 months, as defined by trial authors.
Figuras y tablas -
Analysis 1.15

Comparison 1 Planned caesarean section for term breech presentation, Outcome 15 Postnatal depression at 3 months, as defined by trial authors.

Comparison 1 Planned caesarean section for term breech presentation, Outcome 16 Not breastfeeding at 3 months.
Figuras y tablas -
Analysis 1.16

Comparison 1 Planned caesarean section for term breech presentation, Outcome 16 Not breastfeeding at 3 months.

Comparison 1 Planned caesarean section for term breech presentation, Outcome 17 Perineal pain at 3 months.
Figuras y tablas -
Analysis 1.17

Comparison 1 Planned caesarean section for term breech presentation, Outcome 17 Perineal pain at 3 months.

Comparison 1 Planned caesarean section for term breech presentation, Outcome 18 Abdominal pain at 3 months.
Figuras y tablas -
Analysis 1.18

Comparison 1 Planned caesarean section for term breech presentation, Outcome 18 Abdominal pain at 3 months.

Comparison 1 Planned caesarean section for term breech presentation, Outcome 19 Backache after at 3 months.
Figuras y tablas -
Analysis 1.19

Comparison 1 Planned caesarean section for term breech presentation, Outcome 19 Backache after at 3 months.

Comparison 1 Planned caesarean section for term breech presentation, Outcome 20 Any pain after at 3 months.
Figuras y tablas -
Analysis 1.20

Comparison 1 Planned caesarean section for term breech presentation, Outcome 20 Any pain after at 3 months.

Comparison 1 Planned caesarean section for term breech presentation, Outcome 21 Dyspareunia at 3 months.
Figuras y tablas -
Analysis 1.21

Comparison 1 Planned caesarean section for term breech presentation, Outcome 21 Dyspareunia at 3 months.

Comparison 1 Planned caesarean section for term breech presentation, Outcome 22 Urinary incontinence at 3 months.
Figuras y tablas -
Analysis 1.22

Comparison 1 Planned caesarean section for term breech presentation, Outcome 22 Urinary incontinence at 3 months.

Comparison 1 Planned caesarean section for term breech presentation, Outcome 23 Flatus incontinence at 3 months.
Figuras y tablas -
Analysis 1.23

Comparison 1 Planned caesarean section for term breech presentation, Outcome 23 Flatus incontinence at 3 months.

Comparison 1 Planned caesarean section for term breech presentation, Outcome 24 Faecal incontinence at 3 months.
Figuras y tablas -
Analysis 1.24

Comparison 1 Planned caesarean section for term breech presentation, Outcome 24 Faecal incontinence at 3 months.

Comparison 1 Planned caesarean section for term breech presentation, Outcome 25 Headache at 2 years.
Figuras y tablas -
Analysis 1.25

Comparison 1 Planned caesarean section for term breech presentation, Outcome 25 Headache at 2 years.

Comparison 1 Planned caesarean section for term breech presentation, Outcome 26 Perineal pain at 2 years.
Figuras y tablas -
Analysis 1.26

Comparison 1 Planned caesarean section for term breech presentation, Outcome 26 Perineal pain at 2 years.

Comparison 1 Planned caesarean section for term breech presentation, Outcome 27 Back pain at 2 years.
Figuras y tablas -
Analysis 1.27

Comparison 1 Planned caesarean section for term breech presentation, Outcome 27 Back pain at 2 years.

Comparison 1 Planned caesarean section for term breech presentation, Outcome 28 Sexual problems at 2 years.
Figuras y tablas -
Analysis 1.28

Comparison 1 Planned caesarean section for term breech presentation, Outcome 28 Sexual problems at 2 years.

Comparison 1 Planned caesarean section for term breech presentation, Outcome 29 Painful intercourse at 2 years.
Figuras y tablas -
Analysis 1.29

Comparison 1 Planned caesarean section for term breech presentation, Outcome 29 Painful intercourse at 2 years.

Comparison 1 Planned caesarean section for term breech presentation, Outcome 30 Urinary incontinence at 2 years.
Figuras y tablas -
Analysis 1.30

Comparison 1 Planned caesarean section for term breech presentation, Outcome 30 Urinary incontinence at 2 years.

Comparison 1 Planned caesarean section for term breech presentation, Outcome 31 Flatus incontinence at 2 years.
Figuras y tablas -
Analysis 1.31

Comparison 1 Planned caesarean section for term breech presentation, Outcome 31 Flatus incontinence at 2 years.

Comparison 1 Planned caesarean section for term breech presentation, Outcome 32 Faecal incontinence at 2 years.
Figuras y tablas -
Analysis 1.32

Comparison 1 Planned caesarean section for term breech presentation, Outcome 32 Faecal incontinence at 2 years.

Comparison 1 Planned caesarean section for term breech presentation, Outcome 33 Constipation at 2 years.
Figuras y tablas -
Analysis 1.33

Comparison 1 Planned caesarean section for term breech presentation, Outcome 33 Constipation at 2 years.

Comparison 1 Planned caesarean section for term breech presentation, Outcome 34 Haemorrhoids at 2 years.
Figuras y tablas -
Analysis 1.34

Comparison 1 Planned caesarean section for term breech presentation, Outcome 34 Haemorrhoids at 2 years.

Comparison 1 Planned caesarean section for term breech presentation, Outcome 35 Subsequent birth or pregnant at 2 years.
Figuras y tablas -
Analysis 1.35

Comparison 1 Planned caesarean section for term breech presentation, Outcome 35 Subsequent birth or pregnant at 2 years.

Comparison 1 Planned caesarean section for term breech presentation, Outcome 36 Subsequent caesarean section at 2 years.
Figuras y tablas -
Analysis 1.36

Comparison 1 Planned caesarean section for term breech presentation, Outcome 36 Subsequent caesarean section at 2 years.

Comparison 1 Planned caesarean section for term breech presentation, Outcome 37 Painful menstrual periods at 2 years.
Figuras y tablas -
Analysis 1.37

Comparison 1 Planned caesarean section for term breech presentation, Outcome 37 Painful menstrual periods at 2 years.

Comparison 1 Planned caesarean section for term breech presentation, Outcome 38 Heavy menstrual periods at 2 years.
Figuras y tablas -
Analysis 1.38

Comparison 1 Planned caesarean section for term breech presentation, Outcome 38 Heavy menstrual periods at 2 years.

Comparison 1 Planned caesarean section for term breech presentation, Outcome 39 Depression at 2 years.
Figuras y tablas -
Analysis 1.39

Comparison 1 Planned caesarean section for term breech presentation, Outcome 39 Depression at 2 years.

Comparison 1 Planned caesarean section for term breech presentation, Outcome 40 Difficulty caring for child at 2 years.
Figuras y tablas -
Analysis 1.40

Comparison 1 Planned caesarean section for term breech presentation, Outcome 40 Difficulty caring for child at 2 years.

Comparison 1 Planned caesarean section for term breech presentation, Outcome 41 Relationship with partner unhappy at 2 years.
Figuras y tablas -
Analysis 1.41

Comparison 1 Planned caesarean section for term breech presentation, Outcome 41 Relationship with partner unhappy at 2 years.

Comparison 1 Planned caesarean section for term breech presentation, Outcome 42 Unhappy with sexual relations at 2 years.
Figuras y tablas -
Analysis 1.42

Comparison 1 Planned caesarean section for term breech presentation, Outcome 42 Unhappy with sexual relations at 2 years.

Comparison 1 Planned caesarean section for term breech presentation, Outcome 43 Estimated cost of intervention (in Canadian dollars).
Figuras y tablas -
Analysis 1.43

Comparison 1 Planned caesarean section for term breech presentation, Outcome 43 Estimated cost of intervention (in Canadian dollars).

Summary of findings for the main comparison. Planned caesarean section for term breech delivery

Planned caesarean section for term breech delivery

Patient or population: women with term breech delivery
Settings: 3 studies (2 in the USA, 1 international multicentre trial: 121 centres in 26 countries)
Intervention: planned caesarean section

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No of Participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk

Corresponding risk

Control

Planned caesarean section

Perinatal/neonatal death or severe neonatal morbidity ‐ Low national perinatal mortality rate

Study population

RR 0.07
(0.02 to 0.29)

1025
(1 study)

⊕⊕⊕⊝
moderate1

57 per 1000

4 per 1000
(1 to 16)

Perinatal/neonatal death or severe neonatal morbidity ‐ High national perinatal mortality rate

Study population

RR 0.66
(0.35 to 1.24)

1053
(1 study)

⊕⊕⊝⊝
low1,2

44 per 1000

29 per 1000
(15 to 54)

Birth trauma, as defined by trial authors

Study population

RR 0.42
(0.16 to 1.1)

2062
(1 study)

⊕⊕⊝⊝
low1,2

14 per 1000

6 per 1000
(2 to 15)

Death or neurodevelopmental delay at age 2 years

Study population

RR 1.09
(0.52 to 2.3)

920
(1 study)

⊕⊕⊝⊝
low1,2

28 per 1000

31 per 1000
(15 to 65)

Caesarean section

Study population

RR 2.04
(1.91 to 2.17)

2396
(3 studies)

⊕⊕⊝⊝
low3,4

448 per 1000

843 per 1000
(717 to 986)

Moderate

522 per 1000

981 per 1000

(835 to 1000)

Short‐term maternal morbidity

Study population

RR 1.29
(1.03 to 1.61)

2396
(3 studies)

⊕⊕⊝⊝
low5

86 per 1000

111 per 1000
(89 to 139)

Moderate

391 per 1000

504 per 1000
(403 to 630)

Any pain after at 3 months

Study population

RR 1.09
(0.93 to 1.29)

1593
(1 study)

⊕⊕⊝⊝
low1,2

250 per 1000

272 per 1000
(232 to 322)

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).

CI: Confidence interval; RR: Risk ratio;

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1 One study with design limitations.
2 Wide confidence interval crossing the line of no effect.
3 Statistical Heterogeneity (I2 > 40%). Direction of effect consistent but size of effect variable.
4 Studies contributing data had design limitations.
5 Studies contributing data had design limitations, with more than 40% of weight from studies with serious design limitations (‐2).

Figuras y tablas -
Summary of findings for the main comparison. Planned caesarean section for term breech delivery
Comparison 1. Planned caesarean section for term breech presentation

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Perinatal/neonatal death or severe neonatal morbidity Show forest plot

1

2078

Risk Ratio (M‐H, Random, 95% CI)

0.23 [0.02, 2.44]

1.1 Low national perinatal mortality rate

1

1025

Risk Ratio (M‐H, Random, 95% CI)

0.07 [0.02, 0.29]

1.2 High national perinatal mortality rate

1

1053

Risk Ratio (M‐H, Random, 95% CI)

0.66 [0.35, 1.24]

2 Death or neurodevelopmental delay at age 2 years Show forest plot

1

920

Risk Ratio (M‐H, Fixed, 95% CI)

1.09 [0.52, 2.30]

3 Perinatal/neonatal mortality (excluding fatal malformations) Show forest plot

3

2388

Risk Ratio (M‐H, Fixed, 95% CI)

0.29 [0.10, 0.86]

3.1 Low national perinatal mortality rate

3

1335

Risk Ratio (M‐H, Fixed, 95% CI)

0.26 [0.03, 2.00]

3.2 High national perinatal mortality rate

1

1053

Risk Ratio (M‐H, Fixed, 95% CI)

0.30 [0.08, 1.09]

4 5 minute Apgar < 7 Show forest plot

3

2375

Risk Ratio (M‐H, Random, 95% CI)

0.43 [0.12, 1.47]

5 5 minute Apgar < 4 Show forest plot

1

2062

Risk Ratio (M‐H, Fixed, 95% CI)

0.11 [0.01, 0.87]

6 Cord blood pH < 7.0 Show forest plot

1

1013

Risk Ratio (M‐H, Fixed, 95% CI)

0.15 [0.03, 0.67]

7 Cord blood base deficit =/> 15 Show forest plot

1

899

Risk Ratio (M‐H, Fixed, 95% CI)

0.30 [0.10, 0.92]

8 Birth trauma, as defined by trial authors Show forest plot

1

2062

Risk Ratio (M‐H, Fixed, 95% CI)

0.42 [0.16, 1.10]

9 Brachial plexus injury Show forest plot

3

2375

Risk Ratio (M‐H, Fixed, 95% CI)

0.35 [0.08, 1.47]

10 Infant medical problems at 2 years Show forest plot

1

843

Risk Ratio (M‐H, Fixed, 95% CI)

1.41 [1.05, 1.89]

11 Neurodevelopmental delay at age 2 years Show forest plot

1

920

Risk Ratio (M‐H, Fixed, 95% CI)

1.74 [0.69, 4.37]

12 Caesarean section Show forest plot

3

2396

Risk Ratio (M‐H, Random, 95% CI)

1.88 [1.60, 2.20]

13 Short‐term maternal morbidity Show forest plot

3

2396

Risk Ratio (M‐H, Fixed, 95% CI)

1.29 [1.03, 1.61]

14 Woman not satisfied Show forest plot

1

1596

Risk Ratio (M‐H, Fixed, 95% CI)

1.0 [0.64, 1.56]

15 Postnatal depression at 3 months, as defined by trial authors Show forest plot

1

1586

Risk Ratio (M‐H, Fixed, 95% CI)

0.93 [0.70, 1.24]

16 Not breastfeeding at 3 months Show forest plot

1

1557

Risk Ratio (M‐H, Fixed, 95% CI)

1.04 [0.90, 1.21]

17 Perineal pain at 3 months Show forest plot

1

1593

Risk Ratio (M‐H, Fixed, 95% CI)

0.32 [0.18, 0.58]

18 Abdominal pain at 3 months Show forest plot

1

1593

Risk Ratio (M‐H, Fixed, 95% CI)

1.89 [1.29, 2.79]

19 Backache after at 3 months Show forest plot

1

1593

Risk Ratio (M‐H, Fixed, 95% CI)

0.93 [0.71, 1.22]

20 Any pain after at 3 months Show forest plot

1

1593

Risk Ratio (M‐H, Fixed, 95% CI)

1.09 [0.93, 1.29]

21 Dyspareunia at 3 months Show forest plot

1

1329

Risk Ratio (M‐H, Fixed, 95% CI)

0.91 [0.72, 1.14]

22 Urinary incontinence at 3 months Show forest plot

1

1595

Risk Ratio (M‐H, Fixed, 95% CI)

0.62 [0.41, 0.93]

23 Flatus incontinence at 3 months Show forest plot

1

1222

Risk Ratio (M‐H, Fixed, 95% CI)

1.10 [0.79, 1.53]

24 Faecal incontinence at 3 months Show forest plot

1

1226

Risk Ratio (M‐H, Fixed, 95% CI)

0.54 [0.18, 1.62]

25 Headache at 2 years Show forest plot

1

917

Risk Ratio (M‐H, Fixed, 95% CI)

1.05 [0.88, 1.25]

26 Perineal pain at 2 years Show forest plot

1

917

Risk Ratio (M‐H, Fixed, 95% CI)

0.65 [0.36, 1.15]

27 Back pain at 2 years Show forest plot

1

917

Risk Ratio (M‐H, Fixed, 95% CI)

1.03 [0.88, 1.20]

28 Sexual problems at 2 years Show forest plot

1

917

Risk Ratio (M‐H, Fixed, 95% CI)

0.95 [0.62, 1.48]

29 Painful intercourse at 2 years Show forest plot

1

830

Risk Ratio (M‐H, Fixed, 95% CI)

1.48 [0.53, 4.12]

30 Urinary incontinence at 2 years Show forest plot

1

917

Risk Ratio (M‐H, Fixed, 95% CI)

0.82 [0.63, 1.06]

31 Flatus incontinence at 2 years Show forest plot

1

917

Risk Ratio (M‐H, Fixed, 95% CI)

1.14 [0.81, 1.61]

32 Faecal incontinence at 2 years Show forest plot

1

917

Risk Ratio (M‐H, Fixed, 95% CI)

1.11 [0.47, 2.58]

33 Constipation at 2 years Show forest plot

1

917

Risk Ratio (M‐H, Fixed, 95% CI)

1.34 [1.06, 1.70]

34 Haemorrhoids at 2 years Show forest plot

1

917

Risk Ratio (M‐H, Fixed, 95% CI)

1.10 [0.85, 1.43]

35 Subsequent birth or pregnant at 2 years Show forest plot

1

917

Risk Ratio (M‐H, Fixed, 95% CI)

0.93 [0.71, 1.24]

36 Subsequent caesarean section at 2 years Show forest plot

1

917

Risk Ratio (M‐H, Fixed, 95% CI)

1.24 [0.60, 2.55]

37 Painful menstrual periods at 2 years Show forest plot

1

917

Risk Ratio (M‐H, Fixed, 95% CI)

0.90 [0.71, 1.15]

38 Heavy menstrual periods at 2 years Show forest plot

1

917

Risk Ratio (M‐H, Fixed, 95% CI)

1.09 [0.78, 1.52]

39 Depression at 2 years Show forest plot

1

917

Risk Ratio (M‐H, Fixed, 95% CI)

0.89 [0.62, 1.29]

40 Difficulty caring for child at 2 years Show forest plot

1

873

Risk Ratio (M‐H, Fixed, 95% CI)

0.96 [0.72, 1.29]

41 Relationship with partner unhappy at 2 years Show forest plot

1

856

Risk Ratio (M‐H, Fixed, 95% CI)

1.02 [0.63, 1.66]

42 Unhappy with sexual relations at 2 years Show forest plot

1

702

Risk Ratio (M‐H, Fixed, 95% CI)

0.87 [0.51, 1.50]

43 Estimated cost of intervention (in Canadian dollars) Show forest plot

1

1027

Mean Difference (IV, Fixed, 95% CI)

‐877.0 [‐894.89, ‐859.11]

43.1 Low national perinatal mortality rate

1

1027

Mean Difference (IV, Fixed, 95% CI)

‐877.0 [‐894.89, ‐859.11]

Figuras y tablas -
Comparison 1. Planned caesarean section for term breech presentation