Skip to main content

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