Summary of findings of effects of VWF levels in women receiving neuraxial anesthesia during delivery
| . | |||
|---|---|---|---|
| Outcomes . | Impact . | Participants, n (studies) . | Certainty of the evidence (GRADE) . |
| Complications of epidural assessed as number of events/administration | The pooled proportion of complications of an epidural was 6% (5/83 deliveries). In 4 studies, the types of complications were not reported. In 1 of the studies, the complications reported were hypotension, accidental dural puncture, inadequate analgesia, bloody tap with no further complications, and failed block requiring general anesthesia. | 83 (5 observational studies) | ⨁◯◯◯ VERY LOW*,† |
| Failed procedure assessed as number of events/administration | In the study that reported this outcome, the proportion of deliveries in which it occurred was 2.4% (1/41 deliveries). | 41 (1 observational study) | ⨁◯◯◯ VERY LOW*,† |
| . | |||
|---|---|---|---|
| Outcomes . | Impact . | Participants, n (studies) . | Certainty of the evidence (GRADE) . |
| Complications of epidural assessed as number of events/administration | The pooled proportion of complications of an epidural was 6% (5/83 deliveries). In 4 studies, the types of complications were not reported. In 1 of the studies, the complications reported were hypotension, accidental dural puncture, inadequate analgesia, bloody tap with no further complications, and failed block requiring general anesthesia. | 83 (5 observational studies) | ⨁◯◯◯ VERY LOW*,† |
| Failed procedure assessed as number of events/administration | In the study that reported this outcome, the proportion of deliveries in which it occurred was 2.4% (1/41 deliveries). | 41 (1 observational study) | ⨁◯◯◯ VERY LOW*,† |
VWF levels 50-150 IU/dL compared with VWF levels >150 IU/dL in women with VWD in labor who require or desire epidural anesthesia. The following outcomes: major bleeding, adverse events in mother, spinal hematoma, mortality, thrombotic events, and transfusion were not reported in any of the studies.
GRADE Working Group grades of evidence:
High certainty: we are very confident that the true effect lies close to that of the estimate of the effect.
Moderate certainty: we are moderately confident in the effect estimate. The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different.
Low certainty: our confidence in the effect estimate is limited. The true effect may be substantially different from the estimate of the effect.
Very low certainty: we have very little confidence in the effect estimate. The true effect is likely to be substantially different from the estimate of effect.
No control group.
Very few events and patients.