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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 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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Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
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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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Comparison 1 Umbilical vein injection of saline solution plus oxytocin versus umbilical vein injection of saline solution (low‐risk women), Outcome 1 Blood transfusion.
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Analysis 1.1

Comparison 1 Umbilical vein injection of saline solution plus oxytocin versus umbilical vein injection of saline solution (low‐risk women), Outcome 1 Blood transfusion.

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Comparison 1 Umbilical vein injection of saline solution plus oxytocin versus umbilical vein injection of saline solution (low‐risk women), Outcome 2 Manual removal of placenta.
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Analysis 1.2

Comparison 1 Umbilical vein injection of saline solution plus oxytocin versus umbilical vein injection of saline solution (low‐risk women), Outcome 2 Manual removal of placenta.

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Comparison 1 Umbilical vein injection of saline solution plus oxytocin versus umbilical vein injection of saline solution (low‐risk women), Outcome 3 Blood loss (by oxytocin dose).
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Analysis 1.3

Comparison 1 Umbilical vein injection of saline solution plus oxytocin versus umbilical vein injection of saline solution (low‐risk women), Outcome 3 Blood loss (by oxytocin dose).

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Comparison 1 Umbilical vein injection of saline solution plus oxytocin versus umbilical vein injection of saline solution (low‐risk women), Outcome 4 Length of the third stage of labour (by dose).
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Analysis 1.4

Comparison 1 Umbilical vein injection of saline solution plus oxytocin versus umbilical vein injection of saline solution (low‐risk women), Outcome 4 Length of the third stage of labour (by dose).

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Comparison 1 Umbilical vein injection of saline solution plus oxytocin versus umbilical vein injection of saline solution (low‐risk women), Outcome 5 Blood loss (by total volume).
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Analysis 1.5

Comparison 1 Umbilical vein injection of saline solution plus oxytocin versus umbilical vein injection of saline solution (low‐risk women), Outcome 5 Blood loss (by total volume).

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Comparison 1 Umbilical vein injection of saline solution plus oxytocin versus umbilical vein injection of saline solution (low‐risk women), Outcome 6 Length of the third stage of labour (by total volume).
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Analysis 1.6

Comparison 1 Umbilical vein injection of saline solution plus oxytocin versus umbilical vein injection of saline solution (low‐risk women), Outcome 6 Length of the third stage of labour (by total volume).

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Comparison 2 Umbilical vein injection of oxytocin only versus umbilical vein injection of placebo (water) after intravenous injection of uterotonic (low‐risk women), Outcome 1 Blood transfusion.
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Analysis 2.1

Comparison 2 Umbilical vein injection of oxytocin only versus umbilical vein injection of placebo (water) after intravenous injection of uterotonic (low‐risk women), Outcome 1 Blood transfusion.

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Comparison 2 Umbilical vein injection of oxytocin only versus umbilical vein injection of placebo (water) after intravenous injection of uterotonic (low‐risk women), Outcome 2 Addition of therapeutic uterotonic.
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Analysis 2.2

Comparison 2 Umbilical vein injection of oxytocin only versus umbilical vein injection of placebo (water) after intravenous injection of uterotonic (low‐risk women), Outcome 2 Addition of therapeutic uterotonic.

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Comparison 2 Umbilical vein injection of oxytocin only versus umbilical vein injection of placebo (water) after intravenous injection of uterotonic (low‐risk women), Outcome 3 Blood loss (by oxytocin dose).
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Analysis 2.3

Comparison 2 Umbilical vein injection of oxytocin only versus umbilical vein injection of placebo (water) after intravenous injection of uterotonic (low‐risk women), Outcome 3 Blood loss (by oxytocin dose).

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Comparison 2 Umbilical vein injection of oxytocin only versus umbilical vein injection of placebo (water) after intravenous injection of uterotonic (low‐risk women), Outcome 4 Length of the third stage of labour (by dose).
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Analysis 2.4

Comparison 2 Umbilical vein injection of oxytocin only versus umbilical vein injection of placebo (water) after intravenous injection of uterotonic (low‐risk women), Outcome 4 Length of the third stage of labour (by dose).

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Comparison 2 Umbilical vein injection of oxytocin only versus umbilical vein injection of placebo (water) after intravenous injection of uterotonic (low‐risk women), Outcome 5 Nausea.
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Analysis 2.5

Comparison 2 Umbilical vein injection of oxytocin only versus umbilical vein injection of placebo (water) after intravenous injection of uterotonic (low‐risk women), Outcome 5 Nausea.

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Comparison 2 Umbilical vein injection of oxytocin only versus umbilical vein injection of placebo (water) after intravenous injection of uterotonic (low‐risk women), Outcome 6 Vomiting.
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Analysis 2.6

Comparison 2 Umbilical vein injection of oxytocin only versus umbilical vein injection of placebo (water) after intravenous injection of uterotonic (low‐risk women), Outcome 6 Vomiting.

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Comparison 3 Umbilical vein injection of saline solution plus oxytocin versus intravenous injection of uterotonic (low‐risk women), Outcome 1 Blood transfusion.
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Analysis 3.1

Comparison 3 Umbilical vein injection of saline solution plus oxytocin versus intravenous injection of uterotonic (low‐risk women), Outcome 1 Blood transfusion.

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Comparison 3 Umbilical vein injection of saline solution plus oxytocin versus intravenous injection of uterotonic (low‐risk women), Outcome 2 Addition of therapeutic uterotonic.
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Analysis 3.2

Comparison 3 Umbilical vein injection of saline solution plus oxytocin versus intravenous injection of uterotonic (low‐risk women), Outcome 2 Addition of therapeutic uterotonic.

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Comparison 4 Umbilical vein injection of saline solution plus oxytocin versus intramuscular/intravenous injection of uterotonic (high‐risk women), Outcome 1 Incidence of postpartum haemorrhage.
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Analysis 4.1

Comparison 4 Umbilical vein injection of saline solution plus oxytocin versus intramuscular/intravenous injection of uterotonic (high‐risk women), Outcome 1 Incidence of postpartum haemorrhage.

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Comparison 4 Umbilical vein injection of saline solution plus oxytocin versus intramuscular/intravenous injection of uterotonic (high‐risk women), Outcome 2 Nausea and vomiting.
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Analysis 4.2

Comparison 4 Umbilical vein injection of saline solution plus oxytocin versus intramuscular/intravenous injection of uterotonic (high‐risk women), Outcome 2 Nausea and vomiting.

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Comparison 1. Umbilical vein injection of saline solution plus oxytocin versus umbilical vein injection of saline solution (low‐risk women)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Blood transfusion Show forest plot

1

78

Risk Ratio (M‐H, Fixed, 95% CI)

3.32 [0.14, 78.97]

1.1 10 units oxytocin

1

78

Risk Ratio (M‐H, Fixed, 95% CI)

3.32 [0.14, 78.97]

2 Manual removal of placenta Show forest plot

3

192

Risk Ratio (M‐H, Fixed, 95% CI)

0.47 [0.11, 2.05]

2.1 10 units oxytocin

2

142

Risk Ratio (M‐H, Fixed, 95% CI)

0.53 [0.10, 2.78]

2.2 20 units oxytocin

1

50

Risk Ratio (M‐H, Fixed, 95% CI)

0.33 [0.01, 7.81]

3 Blood loss (by oxytocin dose) Show forest plot

3

161

Mean Difference (IV, Fixed, 95% CI)

‐18.62 [‐56.86, 19.62]

3.1 10 units oxytocin

1

64

Mean Difference (IV, Fixed, 95% CI)

‐23.0 [‐133.59, 87.59]

3.2 20 units oxytocin

2

97

Mean Difference (IV, Fixed, 95% CI)

‐18.02 [‐58.78, 22.73]

4 Length of the third stage of labour (by dose) Show forest plot

6

369

Mean Difference (IV, Random, 95% CI)

‐1.34 [‐3.47, 0.79]

4.1 10 units oxytocin

3

192

Mean Difference (IV, Random, 95% CI)

0.40 [‐0.86, 1.66]

4.2 20 units oxytocin

3

177

Mean Difference (IV, Random, 95% CI)

‐2.77 [‐6.62, 1.07]

5 Blood loss (by total volume) Show forest plot

3

161

Mean Difference (IV, Fixed, 95% CI)

‐18.62 [‐56.86, 19.62]

5.1 20 mL administered

2

114

Mean Difference (IV, Fixed, 95% CI)

‐35.44 [‐82.53, 11.64]

5.2 30 mL administered

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

5.3 40 mL administered

1

47

Mean Difference (IV, Fixed, 95% CI)

14.0 [‐51.55, 79.55]

6 Length of the third stage of labour (by total volume) Show forest plot

6

369

Mean Difference (IV, Random, 95% CI)

‐1.34 [‐3.47, 0.79]

6.1 20 mL administered

4

242

Mean Difference (IV, Random, 95% CI)

‐1.52 [‐5.38, 2.34]

6.2 30 mL administered

1

80

Mean Difference (IV, Random, 95% CI)

‐1.90 [‐3.97, 0.17]

6.3 40 mL administered

1

47

Mean Difference (IV, Random, 95% CI)

‐0.10 [‐1.03, 0.83]
Figuras y tablas -
Comparison 1. Umbilical vein injection of saline solution plus oxytocin versus umbilical vein injection of saline solution (low‐risk women)
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Comparison 2. Umbilical vein injection of oxytocin only versus umbilical vein injection of placebo (water) after intravenous injection of uterotonic (low‐risk women)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Blood transfusion Show forest plot

1

500

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2 Addition of therapeutic uterotonic Show forest plot

1

500

Risk Ratio (M‐H, Fixed, 95% CI)

0.00 [0.00, 0.05]

3 Blood loss (by oxytocin dose) Show forest plot

1

500

Mean Difference (IV, Fixed, 95% CI)

‐42.48 [‐49.27, ‐35.69]

4 Length of the third stage of labour (by dose) Show forest plot

1

500

Mean Difference (IV, Fixed, 95% CI)

‐5.08 [‐5.57, ‐4.59]

5 Nausea Show forest plot

1

500

Risk Ratio (M‐H, Fixed, 95% CI)

1.50 [1.26, 1.80]

6 Vomiting Show forest plot

1

500

Risk Ratio (M‐H, Fixed, 95% CI)

2.16 [1.75, 2.67]
Figuras y tablas -
Comparison 2. Umbilical vein injection of oxytocin only versus umbilical vein injection of placebo (water) after intravenous injection of uterotonic (low‐risk women)
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Comparison 3. Umbilical vein injection of saline solution plus oxytocin versus intravenous injection of uterotonic (low‐risk women)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Blood transfusion Show forest plot

1

104

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2 Addition of therapeutic uterotonic Show forest plot

1

104

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]
Figuras y tablas -
Comparison 3. Umbilical vein injection of saline solution plus oxytocin versus intravenous injection of uterotonic (low‐risk women)
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Comparison 4. Umbilical vein injection of saline solution plus oxytocin versus intramuscular/intravenous injection of uterotonic (high‐risk women)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Incidence of postpartum haemorrhage Show forest plot

1

120

Risk Ratio (M‐H, Fixed, 95% CI)

3.2 [1.12, 9.15]

2 Nausea and vomiting Show forest plot

1

120

Risk Ratio (M‐H, Fixed, 95% CI)

0.40 [0.02, 8.04]
Figuras y tablas -
Comparison 4. Umbilical vein injection of saline solution plus oxytocin versus intramuscular/intravenous injection of uterotonic (high‐risk women)
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