Planned elective repeat caesarean section versus planned vaginal birth for women with a previous caesarean birth

Jodie M Dodd; Caroline A Crowther; Erasmo Huertas; Jeanne‐Marie Guise; Dell Horey

doi:10.1002/14651858.CD004224.pub3

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Figure 1

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

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Figure 2

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

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Analysis 1.1

Comparison 1 Primary outcome, Outcome 1 Death or serious maternal morbidity.

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Analysis 1.2

Comparison 1 Primary outcome, Outcome 2 Death or serious infant morbidity.

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Analysis 2.1

Comparison 2 Secondary maternal outcomes, Outcome 1 Vaginal birth.

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Analysis 2.2

Comparison 2 Secondary maternal outcomes, Outcome 2 Caesarean section.

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Analysis 2.3

Comparison 2 Secondary maternal outcomes, Outcome 3 Uterine rupture.

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Analysis 2.4

Comparison 2 Secondary maternal outcomes, Outcome 4 Haemorrhage or need for blood transfusion.

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Analysis 2.5

Comparison 2 Secondary maternal outcomes, Outcome 5 Hysterectomy.

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Analysis 2.6

Comparison 2 Secondary maternal outcomes, Outcome 6 Vulval or perineal haematoma.

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Analysis 2.7

Comparison 2 Secondary maternal outcomes, Outcome 7 Deep vein thrombosis.

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Analysis 2.8

Comparison 2 Secondary maternal outcomes, Outcome 8 Pulmonary embolus.

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Analysis 2.9

Comparison 2 Secondary maternal outcomes, Outcome 9 Pneumonia.

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Analysis 2.10

Comparison 2 Secondary maternal outcomes, Outcome 10 Adult respiratory distress syndrome.

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Analysis 2.11

Comparison 2 Secondary maternal outcomes, Outcome 11 Wound Infection.

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Analysis 2.12

Comparison 2 Secondary maternal outcomes, Outcome 12 Wound dehiscence.

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Analysis 2.13

Comparison 2 Secondary maternal outcomes, Outcome 13 Organ damage.

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Analysis 2.14

Comparison 2 Secondary maternal outcomes, Outcome 14 Development of fistula.

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Analysis 2.15

Comparison 2 Secondary maternal outcomes, Outcome 15 Bowel obstruction.

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Analysis 2.16

Comparison 2 Secondary maternal outcomes, Outcome 16 Pulmonary oedema.

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Analysis 2.17

Comparison 2 Secondary maternal outcomes, Outcome 17 Stroke.

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Analysis 2.18

Comparison 2 Secondary maternal outcomes, Outcome 18 Cardiac arrest.

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Analysis 2.19

Comparison 2 Secondary maternal outcomes, Outcome 19 Respiratory arrest.

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Analysis 2.20

Comparison 2 Secondary maternal outcomes, Outcome 20 Maternal death.

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Analysis 3.1

Comparison 3 Secondary infant outcomes, Outcome 1 Perinatal death.

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Analysis 3.2

Comparison 3 Secondary infant outcomes, Outcome 2 Apgar score less than 7 at 5 minutes.

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Analysis 3.3

Comparison 3 Secondary infant outcomes, Outcome 3 Birthweight.

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Analysis 3.4

Comparison 3 Secondary infant outcomes, Outcome 4 Intensive care unit admission.

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Analysis 3.5

Comparison 3 Secondary infant outcomes, Outcome 5 Birth trauma.

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Analysis 3.6

Comparison 3 Secondary infant outcomes, Outcome 6 Seizures.

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Analysis 3.7

Comparison 3 Secondary infant outcomes, Outcome 7 Neonatal encephalopathy.

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Analysis 3.8

Comparison 3 Secondary infant outcomes, Outcome 8 Severe respiratory distress syndrome.

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Analysis 3.9

Comparison 3 Secondary infant outcomes, Outcome 9 Necrotising enterocolitis.

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Analysis 3.10

Comparison 3 Secondary infant outcomes, Outcome 10 Systemic infection.

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Comparison 1. Primary outcome

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Death or serious maternal morbidity Show forest plot	1	22	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

2 Death or serious infant morbidity Show forest plot	1	22	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

Comparison 1. Primary outcome

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Comparison 2. Secondary maternal outcomes

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Vaginal birth Show forest plot	1	22	Risk Ratio (M‐H, Fixed, 95% CI)	0.34 [0.09, 1.29]

2 Caesarean section Show forest plot	1	22	Risk Ratio (M‐H, Fixed, 95% CI)	1.92 [0.92, 4.01]

3 Uterine rupture Show forest plot	1	22	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

4 Haemorrhage or need for blood transfusion Show forest plot	1	22	Risk Ratio (M‐H, Fixed, 95% CI)	1.2 [0.20, 7.05]

5 Hysterectomy Show forest plot	1	22	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

6 Vulval or perineal haematoma Show forest plot	1	22	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

7 Deep vein thrombosis Show forest plot	1	22	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

8 Pulmonary embolus Show forest plot	1	22	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

9 Pneumonia Show forest plot	1	22	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

10 Adult respiratory distress syndrome Show forest plot	1	22	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

11 Wound Infection Show forest plot	1	22	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

12 Wound dehiscence Show forest plot	1	22	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

13 Organ damage Show forest plot	1	22	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

14 Development of fistula Show forest plot	1	22	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

15 Bowel obstruction Show forest plot	1	22	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

16 Pulmonary oedema Show forest plot	1	22	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

17 Stroke Show forest plot	1	22	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

18 Cardiac arrest Show forest plot	1	22	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

19 Respiratory arrest Show forest plot	1	22	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

20 Maternal death Show forest plot	1	22	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

Comparison 2. Secondary maternal outcomes

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Comparison 3. Secondary infant outcomes

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Perinatal death Show forest plot	1	22	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

2 Apgar score less than 7 at 5 minutes Show forest plot	1	22	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

3 Birthweight Show forest plot	1	22	Mean Difference (IV, Fixed, 95% CI)	‐133.0 [‐513.12, 247.12]

4 Intensive care unit admission Show forest plot	1	22	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

5 Birth trauma Show forest plot	1	22	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

6 Seizures Show forest plot	1	22	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

7 Neonatal encephalopathy Show forest plot	1	22	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

8 Severe respiratory distress syndrome Show forest plot	1	22	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

9 Necrotising enterocolitis Show forest plot	1	22	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

10 Systemic infection Show forest plot	1	22	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

Comparison 3. Secondary infant outcomes

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