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Table 1 Qualitative assessment of overall evidence for Doppler velocimetry and fetal movement monitoring according to CHERG rules

From: Screening and triage of intrauterine growth restriction (IUGR) in general population and high risk pregnancies: a systematic review with a focus on reduction of IUGR related stillbirths

  Quality Assessment Summary of findings
     Generalizability Number of events Pooled Effect
No. of studies Design Limitations Consistency Generalizability to Population of Interest Generalizability to intervention of Interest Intervention control RR ( 95 % CI)
Effect of surveillance of high risk pregnancies with Doppler velocimetry: Outcome perinatal mortality: Grade quality of evidence ‘Moderate’
16 RCT Methods of sequence generation and allocation concealment were not adequate in most of the studies No heterogeneity (I2=0%) All the studies from developed countries except one which is from South Africa Doppler velocimetry of umbilical and fetal arteries for surveillance of high risk pregnancy 63 90 0.71 (0.52-0.98)
Effect of surveillance of high risk pregnancies with Doppler velocimetry: Outcome stillbirth: Grade quality of evidence ‘Low’
15 RCT Methods of sequence generation and allocation concealment were not adequate in most of the studies No heterogeneity (I2=0%) All the studies from developed countries except one which is from South Africa Doppler velocimetry of umbilical and fetal arteries for surveillance of high risk pregnancy 27 43 0.65 (0.41-1.04)
Effect of fetal movement monitoring on stillbirths: Grade quality of evidence “very low”
14 RCT, quasi experimental and observational studies Most of the evidence from observation studies. Of the four RCTs, only one compared fetal movement monitoring versus no fetal movement monitoring. This RCT showed no effect of fetal movement monitoring on stillbirths Data not pooled due to gross clinical heterogeneity Most of the studies from developed countries No consensus on single counting method. Cardif method (Count to ten) was the most widely used method Data not pooled