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Heliyon Oct 2021To this date, there are 4 systematic reviews and meta-analyses studies about the burden and associated factors of birth asphyxia in Ethiopia. However, findings of these...
BACKGROUND
To this date, there are 4 systematic reviews and meta-analyses studies about the burden and associated factors of birth asphyxia in Ethiopia. However, findings of these studies are inconsistent which is difficult to make use of the findings for preventing birth asphyxia in the country. Therefore, umbrella review of these studies is required to pool the inconsistent findings into a single summary estimate that can be easily referred by the information users in Ethiopia.
METHODS
PubMed, Science direct, web of science, data bases specific to systematic reviews such as the Cochrane Database of Systematic Reviews and the Database of Abstracts of Reviews of Effects were searched for systematic reviews and meta-analyses (SRM) studies on the magnitude and risk factors of perinatal asphyxia in Ethiopia. The methodological quality of the included studies was assessed using the Assessment of Multiple Systematic Reviews (AMSTAR) tool. The estimates of the included SRM studies on the prevalence and predictors of perinatal asphyxia were pooled and summarized with random-effects meta-analysis models. From checking PROSPERO, this umbrella review wasn't registered.
RESULTS
We included four SRM studies with a total of 49,417 neonates. The summary estimate for prevalence of birth asphyxia was 22.52% (95% CI = 17.01%-28.02%; I = 0.00). From the umbrella review, the reported factors of statistical significance include: maternal illiteracy [AOR = 1.96; 95% CI: 1.44-2.67], primiparity [AOR = 1.29; 95% CI: 1.03-1.62], antepartum hemorrhage [AOR = 3.43; 95% CI: 1.74-6.77], pregnancy induced hypertension [AOR = 4.35; 95% CI: 2.98-6.36], premature rupture of membrane [AOR = 12.27; 95% CI: 2.41, 62.38], prolonged labor [AOR = 3.18; 95% CI: 2.75, 3.60], meconium-stained amniotic fluid [AOR = 5.94; 95% CI: 4.86, 7.03], instrumental delivery [AOR = 3.39; 95% CI: 2.46, 4.32], non-cephalic presentation [AOR = 3.39; 95% CI: 1.53, 5.26], cord prolapse [AOR = 2.95; 95% CI: 1.64, 5.30], labor induction [AOR = 3.69; 95% CI: 2.26-6.01], cesarean section delivery [AOR = 3.62; 95% CI: 3.36, 3.88], low birth weight [AOR = 6.06; 95% CI: 5.13, 6.98] and prematurity [AOR = 3.94; 95% CI: 3.67, 4.21] at 95% CI.
CONCLUSION
This umbrella review revealed high burden of birth asphyxia in Ethiopia. The study also indicated significant risk of birth asphyxia among mothers who were unable to read and write, primiparous mothers, those mothers having antepartum hemorrhage, pregnancy induced hypertension, premature rupture of membrane, prolonged labor, meconium-stained amniotic fluid, instrumental delivery, cesarean section delivery, non-cephalic presentation, cord prolapse and labor induction. Moreover, low birth weight and premature neonates were more vulnerable to birth asphyxia compared to their normal birth weight and term counterparts. Therefore, burden of birth asphyxia should be mitigated through special consideration of these risk mothers and neonates during antenatal care, labor and delivery. Mitigation of the problem demands the collaborative efforts of national, regional and local stakeholders of maternal and neonatal health.
PubMed: 34746456
DOI: 10.1016/j.heliyon.2021.e08128 -
American Journal of Obstetrics &... Nov 2019The aim of the present meta-analysis was to evaluate the efficacy and safety of early amniotomy performed during induction of labor. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
The aim of the present meta-analysis was to evaluate the efficacy and safety of early amniotomy performed during induction of labor.
DATA SOURCES
The Medline, Embase, and Web-of-Science databases (from conception to end-of-search date, Dec. 31, 2018) were systematically searched.
STUDY ELIGIBILITY CRITERIA
Randomized controlled trials that compared the performance of early amniotomy (performed before active phase of labor) to spontaneous or late amniotomy were eligible for inclusion. Eligible studies were limited to studies published as full articles available in the English language and included patients with a singleton viable fetus at term undergoing induction of labor for any indication.
STUDY APPRAISAL AND SYNTHESIS METHODS
Data were pooled using the random-effects and fixed-effects models after assessing for the presence of heterogeneity. Risk of bias for each included study was assessed based on the criteria outlined in the Cochrane Handbook for Systematic Reviews of Interventions. Primary outcomes were cesarean delivery and time to delivery. Secondary outcomes were intrapartum infectious morbidity, operative delivery, indication for cesarean, cord prolapse, uterine hyperstimulation, meconium-stained amniotic fluid, and neonatal intensive care unit admission. A subanalysis that included only nulliparous patients was performed for the primary outcomes.
RESULTS
There were a total of 7 studies identified that met the inclusion criteria and these studies reported on 1775 patients. The early and late/spontaneous amniotomy groups included 884 and 891 patients, respectively. Patients who had an early amniotomy had a shorter time to delivery (mean difference, -3.62 hours; 95% confidence interval, -.09 to -1.16). When limiting the analysis to the 866 nulliparous women, early amniotomy was associated with a 5 hour shorter time to delivery compared with late amniotomy (mean difference, -5.12 hours; 95% confidence interval, -8.47 to -1.76; I, 89%). There was no difference in the rate of cesarean delivery (relative risk, 1.09; 95% confidence interval, 0.80-1.49) or intrapartum infectious morbidity (relative risk, 1.42; 95% confidence interval, 0.77-2.61) between the 2 groups. There were no differences in any of the other secondary outcomes evaluated.
CONCLUSION
Early amniotomy during induction of labor is associated with faster time to delivery without any evidence of adverse perinatal outcomes.
Topics: Amniotomy; Cesarean Section; Female; Humans; Infant, Newborn; Labor Onset; Labor, Induced; Pregnancy
PubMed: 33345842
DOI: 10.1016/j.ajogmf.2019.100052 -
European Journal of Obstetrics,... Mar 2020Hybrid simulation is defined as the use of a patient actor combined with a task trainer within the same session. We sought to investigate the level of evidence about the...
Hybrid simulation is defined as the use of a patient actor combined with a task trainer within the same session. We sought to investigate the level of evidence about the clinical benefits of hybrid simulation training in obstetrics. We searched MEDLINE using the keywords: Obstetrics AND Medical Education AND (Standardized patient OR Hybrid simulation). A total of 155 studies were screened, from which we selected 11 articles were selected from the title and the abstract in PubMed. For each study, data about the type of simulation, the level of evidence according KirkPatrick's hierarchy was collected. There is evidence that clinical benefit for patients exists for Shoulder Dystocia, and Cord prolapse. For Non-technical skills, such as communication or team training, hybrid simulation was also effective. Whether hybrid simulation offers better training for communication and better immersion than high-fidelity simulation for learners remains to be investigated.
Topics: Clinical Competence; Communication; Delivery, Obstetric; Female; High Fidelity Simulation Training; Humans; Obstetric Labor Complications; Obstetrics; Patient Simulation; Physician-Patient Relations; Postpartum Hemorrhage; Pre-Eclampsia; Pregnancy; Prolapse; Shoulder Dystocia; Simulation Training; Umbilical Cord
PubMed: 31927239
DOI: 10.1016/j.ejogrb.2019.12.024