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BMC Pregnancy and Childbirth Oct 2023Postpartum urinary incontinence substantially impacts the psychophysical well-being of women. The influencing factors contributing to postpartum urinary incontinence... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Postpartum urinary incontinence substantially impacts the psychophysical well-being of women. The influencing factors contributing to postpartum urinary incontinence remain a subject of contention in clinical investigation. By elucidating the factors contributing to postpartum urinary incontinence, more efficacious interventions for laboring women can be devised. Consequently, this review endeavored to scrutinize the repercussions of maternal postpartum urinary incontinence to furnish empirical references for the clinical advancement of preventive strategies.
METHOD
The investigation employed bibliographic databases: Embase, PubMed, Web of Science, Cochrane Library, CBM, VIP, CNKI, and Wan Fang Data for article retrieval. A comprehensive consideration of all study designs was undertaken during the examination of the effects of postpartum urinary incontinence. The temporal limitation was set at all articles prior to February 2023. Studies incorporated laboring mothers experiencing normative labor and parturition. A total of 28,303 women were encompassed in the reviewed investigations.
RESULTS
A total of 5,915 putative citations were identified, from which 32 articles were selected for evaluating the effects of postpartum urinary incontinence. Meta-analyses revealed that the incidence of postpartum urinary incontinence was 26% [95%CI: (21% ~ 30%)]. Twelve pivotal variables were identified to influence postpartum urinary incontinence: cesarean delivery, vaginal delivery, age ≥ 35 years, multiparty (number of deliveries ≥ 2), neonatal weight > 4 kg, perineal dystonia, antecedents of urological incontinence-related pathology, maternal pre-conception BMI ≥ 24 kg/m^2, perineal laceration, instrumental parturition, historical pelvic surgical procedures, and protracted second stage of labor. Among these, cesarean delivery was identified as a protective factor against postpartum urinary incontinence.
CONCLUSION
The study corroborated that anamnestic factors pertinent to urinary incontinence, vaginal parturitions, and neonates with a weight exceeding 4 kg serve as significant risk factors for postpartum urinary incontinence. Cesarean delivery emerged as a protective factor against postpartum urinary incontinence. Based on the prevalence of postpartum urinary incontinence, proactive intervention is requisite to mitigate the risk of postpartum urinary incontinence in postpartum women possessing these risk factors.
TRIAL REGISTRATION
CRD42023412096.
Topics: Adult; Female; Humans; Pregnancy; Delivery, Obstetric; Parturition; Postpartum Period; Prevalence; Urinary Incontinence
PubMed: 37898733
DOI: 10.1186/s12884-023-06059-6 -
BMJ Open Dec 2020To systematically review (1) The effect of obstetric unit (OU) closures on maternal and neonatal outcomes and (2) The association between travel distance/time to an OU... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
To systematically review (1) The effect of obstetric unit (OU) closures on maternal and neonatal outcomes and (2) The association between travel distance/time to an OU and maternal and neonatal outcomes.
DESIGN
Systematic review of any quantitative studies with a comparison group.
DATA SOURCES
Embase, MEDLINE, PsycINFO, Applied Social Science Index and Abstracts, Cumulative Index to Nursing and Allied Health and grey literature were searched.
METHODS
Eligible studies explored the impact of closure of an OU or the effect of travel distance/time on prespecified maternal or neonatal outcomes. Only studies of women giving birth in high-income countries with universal health coverage of maternity services comparable to the UK were included. Identification of studies, extraction of data and risk of bias assessment were undertaken by at least two reviewers independently. The risk of bias checklist was based on the Cochrane Effective Practice and Organisation of Care criteria and the Newcastle-Ottawa scale. Heterogeneity across studies precluded meta-analysis and synthesis was narrative, with key findings tabulated.
RESULTS
31 studies met the inclusion criteria. There was some evidence to suggest an increase in babies born before arrival following OU closures and/or associated with longer travel distances or time. This may be associated with an increased risk of perinatal or neonatal mortality, but this finding was not consistent across studies. Evidence on other maternal and neonatal outcomes was limited but did not suggest worse outcomes after closures or with longer travel times/distances. Interpretation of findings for some studies was hampered by concerns around how accurately exposures were measured, and/or a lack of adjustment for confounders or temporal changes.
CONCLUSION
It is not possible to conclude from this review whether OU closure, increased travel distances or times are associated with worse outcomes for the mother or the baby.
PROSPERO REGISTRATION NUMBER
CRD42017078503.
Topics: Developed Countries; Female; Humans; Income; Infant; Infant Mortality; Infant, Newborn; Pregnancy
PubMed: 33318106
DOI: 10.1136/bmjopen-2020-036852 -
European Journal of Midwifery 2021Midwives experiencing traumatic births are emotionally affected by this process, lose their self-confidence, and may intend to leave the profession. This study aims to... (Review)
Review
INTRODUCTION
Midwives experiencing traumatic births are emotionally affected by this process, lose their self-confidence, and may intend to leave the profession. This study aims to carry out a meta-synthesis of current qualitative research exploring the experiences of midwives witnessing traumatic births.
METHODS
The meta-synthesis consisted of 18 full-text studies in English, obtained from PubMed, Scopus, Web of Sciences, Cumulative Index of Nursing and Allied Health Literature (CINAHL), EMBASE, and PsycINFO databases. The results of the studies were analyzed using the thematic analysis technique. The study includes qualitative, mixedmethod, and full-text studies published between 2000 and 2020 that explored the experiences of midwives and obstetric nurses witnessing birth trauma.
RESULTS
The thematic analysis identified seven themes: post-traumatic feelings, posttraumatic stress symptoms, the impact of trauma on professional values, social support, learning from experience, legal process, and reflection of emotions of women experiencing traumatic birth on the midwife.
CONCLUSIONS
Midwives who witnessed traumatic birth were mostly emotionally affected. They lost their self-confidence and intended to leave their profession. They emphasized the importance of peer support through which they could share their experiences after trauma. Psychological education should be provided to midwives who witness the trauma by specialists, and midwives should be strengthened against the effects of trauma in terms of both the institutional policies where the birth takes place and midwifery-specific legal policies.
PubMed: 34386725
DOI: 10.18332/ejm/138197 -
Iranian Journal of Public Health Oct 2020Considering that the obstetricians and pediatricians need to comprehensive information about the obstetric and neonatal effect of COVID-19, this review study was... (Review)
Review
BACKGROUND
Considering that the obstetricians and pediatricians need to comprehensive information about the obstetric and neonatal effect of COVID-19, this review study was conducted to investigate the impact of COVID-19 on obstetrics and neonatal outcomes.
METHODS
In this systematic review the international search databases following PubMed, Web of Science, Scopus, ProQuest and Embase and Google scholar were searched. All articles were reviewed by two independent researchers until 10 April 2020. After quality assessment of included studies the finding reported in 2 sections obstetrics and neonatal outcomes.
RESULTS
The sixteen studies with a sample size of 123 pregnant women with a definitive diagnosis of COVID-19 and their neonates were evaluated. The range of gestational age was 25-40 weeks. There was no death associated with COVID-19 in pregnant women. The obstetric outcomes in pregnant women with COVID-19 include decreased fetal movement, intrauterine fetal distress, anemia, PROM, preterm labor, Multiple Organ Dysfunction Syndrome (MODS) and etc. The most common delivery mode in women affect with COVID-19 was cesarean section. Expect for one case with MODS, in the majority of the studies reviewed, no severe morbidity or mortality occurred. The neonatal outcomes were stillbirth, prematurity, asphyxia, fetal distress, low birth weight, small for gestational age, large for gestational age, multiple organ dysfunction syndrome, disseminated intravascular coagulation and neonatal death. In addition, five neonates born to mothers with COVID-19 were positive for SARS-CoV-2. However, the studies report these outcomes but the exact causes of theme are not known.
CONCLUSION
In this systematic review, we summarize the diverse results of studies about the obstetrics and neonatal outcomes following COVID-19. This infection may cause negative outcomes in both mothers and neonates. However, there were evidence about neonate infected with COVID-19, but there is controversial information about the vertical transmission of COVID-19.
PubMed: 34268204
DOI: 10.18502/ijph.v49iS1.3668 -
Annals of Palliative Medicine Dec 2021The timing of urinary catheter removal after gynecological and obstetric surgery remains controversial. This meta-analysis investigated the optimal timing of urinary... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The timing of urinary catheter removal after gynecological and obstetric surgery remains controversial. This meta-analysis investigated the optimal timing of urinary catheter removal.
METHODS
The PubMed, Ovid Medline, Cochrane, and Embase databases were searched for literatures published between 2010 and 2021 relating to randomized controlled studies examining the timing of catheter removal. The modified Joanna Briggs Institute (JBI) scoring criteria was used to assess the quality of the literatures. After extracting the literature data, the Revman 5.3 software was used for analysis and to obtain the statistical forest plots.
RESULTS
A total of 345 literatures were screened and 11 literatures were finally included. Meta-analysis showed that there was no statistical difference in the occurrence of urinary tract infection (UTI) rate between extubation at 6 hours and immediately after surgery [odds ratio (OR) =1.66; 95% confidence interval (CI): 0.58 to 4.81; P=0.35], but the urinary retention rate was significantly lower in patients who were extubated at 6 hours post-surgery compared to immediately after surgery (OR =0.06; 95% CI: 0.01 to 0.36; P=0.002). In patients who were extubated at 12 hours post-operation, the rate of UTI was significantly higher than immediate extubation post-operation (OR =2.32; 95% CI: 1.31 to 4.10; P=0.004), while the probability of urinary retention was significantly lower than extubated immediate (OR =0.18; 95% CI: 0.04 to 0.83; P=0.03). Similarly, in patients who were extubated at 24 hours post-operation, the UTI rate was significantly higher than that patients who were immediately extubated (OR =4.51; 95% CI: 2.02 to 10.09; P=0.0002) and the urinary retention rate was significantly lower than extubated immediately (OR =0.06; 95% CI: 0.01 to 0.32; P=0.001). The UTI rate of patients who were extubated 48 hours after surgery was not significantly different from that of patients extubated 24 hours after surgery (OR =1.62; 95% CI: 0.76 to 3.45; P=0.21) and the incidence of urinary retention was not significantly different (OR =0.28; 95% CI: 0.07 to 1.18; P=0.08).
DISCUSSION
The optimal time for removal of the urinary catheter is 6 hours after gynecological and obstetric surgery.
Topics: Airway Extubation; Catheters, Indwelling; Female; Humans; Obstetric Surgical Procedures; Pregnancy; Time Factors; Urinary Catheters
PubMed: 35016455
DOI: 10.21037/apm-21-3290 -
BMC Pregnancy and Childbirth Sep 2022Obstetric fistula used as synonymous with VVF in this study, is an abnormal communication/hole between the urinary tract and the genital tract or the gastrointestinal...
BACKGROUND
Obstetric fistula used as synonymous with VVF in this study, is an abnormal communication/hole between the urinary tract and the genital tract or the gastrointestinal tract and the genital tract, resulting from prolonged obstructed labour. VVF may cause sufferers to experience chronic urinary/faecal incontinence, and the stigma of continuing foul odour. VVF is primarily caused by prolonged obstructed labour, which is brought about by a range of causes. Recently, it has been proposed that women's groups and fistula survivors should suggest interventions to reduce or prevent the incidence of obstetric fistula.
OBJECTIVE
The objective of this review was to synthesise what is reported about women's views and experiences of the risk factors underlying the causes of VVF.
METHODS
A systematic approach outlined in the Joanna Briggs Institute Manual for Evidence synthesis was followed for this review, articles published since the last 11 years from 2011 to 2021 were selected against several criteria and critically appraised using JBI Critical Appraisal Checklist for qualitative studies.
RESULTS
Nine studies were retained for inclusion in this review and the data were then synthesised into five themes: (1) Cultural beliefs and practices impeding safe childbirth, (2) Lack of woman's autonomy in choices of place to birth safely, (3) Lack of accessibility and social support to safe childbirth, (4) Inexperienced birth attendants and, (5) Delayed emergency maternal care (childbirth).
CONCLUSIONS
This review highlights the complexity of risk factors predisposing women to the known causes of VVF. It also illuminates the absence of women's voices in the identification of solutions to these risks. Women are most directly affected by VVF. Therefore, their knowledge, views, and experiences should be considered in the development and implementation of strategies to address the issue. Exploring women's views on this issue would enable the identification of gaps in maternity care provision, which would be of interest to community and health service leaders as well as policymakers in Sub-Saharan Africa.
Topics: Africa South of the Sahara; Delivery, Obstetric; Female; Humans; Maternal Health Services; Parturition; Pregnancy; Qualitative Research; Risk Factors; Urinary Incontinence
PubMed: 36057559
DOI: 10.1186/s12884-022-05013-2 -
Annals of Internal Medicine Jan 2024Severe maternal morbidity and mortality are worse in the United States than in all similar countries, with the greatest effect on Black women. Emerging research suggests... (Review)
Review
BACKGROUND
Severe maternal morbidity and mortality are worse in the United States than in all similar countries, with the greatest effect on Black women. Emerging research suggests that disrespectful care during childbirth contributes to this problem.
PURPOSE
To conduct a systematic review on definitions and valid measurements of respectful maternity care (RMC), its effectiveness for improving maternal and infant health outcomes for those who are pregnant and postpartum, and strategies for implementation.
DATA SOURCES
Systematic searches of Ovid Medline, CINAHL, Embase, Cochrane Central Register of Controlled Trials, PsycInfo, and SocINDEX for English-language studies (inception to July 2023).
STUDY SELECTION
Randomized controlled trials and nonrandomized studies of interventions of RMC versus usual care for effectiveness studies; additional qualitative and noncomparative validation studies for definitions and measurement studies.
DATA EXTRACTION
Dual data abstraction and quality assessment using established methods, with resolution of disagreements through consensus.
DATA SYNTHESIS
Thirty-seven studies were included across all questions, of which 1 provided insufficient evidence on the effectiveness of RMC to improve maternal outcomes and none studied RMC to improve infant outcomes. To define RMC, authors identified 12 RMC frameworks, from which 2 main concepts were identified: and frameworks. Disrespect and abuse components focused on recognizing birth mistreatment; rights-based frameworks incorporated aspects of reproductive justice, human rights, and antiracism. Five overlapping framework themes include freedom from abuse, consent, privacy, dignity, communication, safety, and justice. Twelve tools to measure RMC were validated in 24 studies on content validity, construct validity, and internal consistency, but lack of a gold standard limited evaluation of criterion validity. Three tools specific for RMC had at least 1 study demonstrating consistency internally and with an intended construct relevant to U.S. settings, but no single tool stands out as the best measure of RMC.
LIMITATIONS
No studies evaluated other health outcomes or RMC implementation strategies. The lack of definition and gold standard limit evaluation of RMC tools.
CONCLUSION
Frameworks for RMC are well described but vary in their definitions. Tools to measure RMC demonstrate consistency but lack a gold standard, requiring further evaluation before implementation in U.S. settings. Evidence is lacking on the effectiveness of implementing RMC to improve any maternal or infant health outcome.
PRIMARY FUNDING SOURCE
Agency for Healthcare Research and Quality. (PROSPERO: CRD42023394769).
Topics: Infant; Pregnancy; Female; Humans; Maternal Health Services; Respect; Obstetrics; Delivery, Obstetric; Postpartum Period; Quality of Health Care
PubMed: 38163377
DOI: 10.7326/M23-2676 -
BMC Pregnancy and Childbirth Aug 2015Obstetric fistula (OF) is a serious consequence of prolonged, obstructed labor in settings where emergency obstetric care is limited, but there are few reliable,... (Review)
Review
BACKGROUND
Obstetric fistula (OF) is a serious consequence of prolonged, obstructed labor in settings where emergency obstetric care is limited, but there are few reliable, population-based estimates of the rate of OF. Stillbirth (SB) is another serious consequence of prolonged, obstructed labor, yet the frequency of SB in women with OF is poorly described. Here, we review these data.
METHODS
We searched electronic databases and grey literature for articles on OF in low-resource countries published between January 1, 1995, and November 16, 2014, and selected for inclusion 19 articles with original population-based OF incidence or prevalence data and 44 with reports of frequency of SB associated with OF.
RESULTS
OF estimates came from medium- and low-HDI countries in South Asia and Africa, and varied considerably; incidence estimates ranged from 0 to 4.09 OF cases per 1000 deliveries, while prevalence estimates were judged more prone to bias and ranged from 0 to 81.0 OF cases per 1000 women. Reported frequency of SB associated with OF ranged from 32.3 % to 100 %, with estimates from the largest studies around 92 %. Study methods and quality were inconsistent.
CONCLUSIONS
Reliable data on OF and associated SB in low-resource countries are lacking, underscoring the relative invisibility of these issues. Sound numbers are needed to guide policy and funding responses to these neglected conditions of poverty.
Topics: Adult; Africa South of the Sahara; Asia; Developing Countries; Female; Health Resources; Humans; Incidence; Maternal Health Services; Medically Underserved Area; Needs Assessment; Obstetric Labor Complications; Pregnancy; Prevalence; Risk Assessment; Stillbirth; Vesicovaginal Fistula; Young Adult
PubMed: 26306705
DOI: 10.1186/s12884-015-0592-2 -
Nursing Open Sep 2021This study aimed to determine effectiveness of peanut ball on the duration of the stages of labour and frequency of caesarean section. (Meta-Analysis)
Meta-Analysis Review
AIM
This study aimed to determine effectiveness of peanut ball on the duration of the stages of labour and frequency of caesarean section.
DESIGN
A systematic review and meta-analysis.
METHOD
A comprehensive electronic search was carried out with no time limit until December 2020. Collected data were analysed using software RevMan- version 5.3. Heterogeneity was assessed using I , T , and . GRADE approach was used to assess the certainty of evidence.
RESULTS
The meta-analysis on six clinical trials with 645 participants showed no statistically significant difference between the two groups in caesarean surgery rate (RR = 0.82) and length of the first (MD = -15.64).
CONCLUSIONS
Therefore, further clinical trials with stronger evidence should be carried out to assess the effectiveness of peanut ball on caesarean surgery rate and length of first and second stages of labour.
Topics: Humans; Pregnancy; Arachis; Cesarean Section; Labor, Obstetric; Female
PubMed: 33773071
DOI: 10.1002/nop2.844 -
Sexual & Reproductive Healthcare :... Jun 2018
Review
Topics: Attitude; Caregivers; Delivery, Obstetric; Emotions; Female; Humans; Mother-Child Relations; Mothers; Object Attachment; Parturition; Personal Satisfaction; Pregnancy; Psychological Trauma; Stress, Psychological
PubMed: 29804779
DOI: 10.1016/j.srhc.2018.02.007