Intraoperative Cell Salvage for Women at High Risk of Postpartum Hemorrhage During Cesarean Section: a Systematic Review and Meta-analysis

2022 ◽  
Author(s):  
Nathan Obore ◽  
Zhang Liuxiao ◽  
Yu Haomin ◽  
Tao Yuchen ◽  
Lina Wang ◽  
...  
Keyword(s):  
Systematic Review ◽  
High Risk ◽  
Cesarean Section ◽  
Postpartum Hemorrhage ◽  
Meta Analysis ◽  
Cell Salvage ◽  
Intraoperative Cell Salvage

Is General Anesthesia for Cesarean Section Associated With Postpartum Hemorrhage? Systematic Review and Meta-Analysis

2014 ◽  
Vol 34 (3) ◽  
pp. 138-139
Author(s):  
M. Heesen ◽  
T. Hofmann ◽  
S. Klöhr ◽  
R. Rossaint ◽  
M. van de Velde ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cesarean Section ◽  
General Anesthesia ◽  
Postpartum Hemorrhage ◽  
Meta Analysis

Intrauterine Cleaning after Placental Delivery at Cesarean Section: A systematic review and Meta-Analysis

2021 ◽  
Vol 17 ◽  
Author(s):  
Rana Doosti ◽  
Sakineh Mohammad-Alizadeh-Charandabi ◽  
Parivash Ahmadpour ◽  
Mojgan Mirghafourvand
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Cesarean Section ◽  
Postpartum Hemorrhage ◽  
Perioperative Complications ◽  
Meta Analysis ◽  
Experimental Studies ◽  
Secondary Outcome ◽  
Control Group ◽  
Significant Difference

Introduction: The increasing rate of cesarean section and its greater number of complications compared to vaginal childbirth invoke efforts to reduce perioperative complications through evidence-based techniques. Objective: The present study mainly aims to assess the effect of intrauterine cleaning after placental delivery in the cesarean section on the frequency of endometritis (primary outcome) and postpartum hemorrhage (secondary outcome). Material and Methods: In this systematic review we have followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. Both English and Persian databases were searched (with no time limit) for clinical trials and quasi-experimental studies that had investigated the effect of intrauterine cleaning after placental delivery in the cesarean section on the frequency of endometritis and hemorrhage compared to a control group (no intrauterine cleaning). Results: The meta-analysis on three clinical trials with 696 participants showed no significant difference between intervention and control groups in the frequency of endometritis (RR= 1.33; 95% CI: 0.74 to 2.41; P= 0.34) and postpartum hemorrhage (RR= 1.06; 95% CI: 0.55 to 2.06; P= 0.86). Conclusions: Based on the meta-analysis results, intrauterine cleaning after placental delivery in the cesarean section does not affect endometritis and postpartum hemorrhage. Further and more robust studies based on the Consort Declaration are required to investigate this method to be recommended for use in clinical practice.

Maternal and Neonatal Effect of Fentanyl as a Premedication before Induction of General Anesthesia in Cesarean Surgery: A Systematic Review and Meta-analysis of Randomized Clinical Trials

2019 ◽  
Vol 15 (4) ◽  
pp. 232-237
Author(s):  
Mir Hadi Musavi ◽  
Behzad Jodeiri ◽  
Keyvan Mirnia ◽  
Morteza Ghojazadeh ◽  
Zeinab Nikniaz
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Cesarean Section ◽  
General Anesthesia ◽  
Apgar Score ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Intravenous Fentanyl ◽  
Neonatal Effect ◽  
Fentanyl Group

Background: Although, some clinical trials investigated the maternal and neonatal effect of fentanyl as a premedication before induction of general anesthesia in cesarean section, to the best of our knowledge, there is no systematic review to summarize these results. Objectives: The present systematic review and meta-analysis evaluated the maternal and neonatal effect of intravenous fentanyl as a premedication before induction of general anesthesia in cesarean section. Methods: The databases of Pubmed, Embase, Scopus and Cochrane library were searched till July 2017 to identify randomized clinical trials which evaluated the effects of intravenous fentanyl as a premedication before induction of general anesthesia compared with placebo on neonate first and fifth minute Apgar score and maternal heart rate and mean arterial pressure (MAP) in cesarean section. Standard Mean difference (SMD) was calculated and I-square statistic test was used for heterogeneity analysis. Results: The present systematic review and meta-analysis consisted of three clinical trials including 180 women in labor. Considering the results of meta-analysis, there is no significant differences between fentanyl and placebo in the case of Apgar score at 1 minute; however, the Apgar score of 5 minutes was significantly lower in fentanyl group compared with placebo (SMD -0.68, 95%CI: - 0.98, -0.38, p<0.001). In the term of maternal hemodynamics, the heart rate (SMD -0.43, 95%CI: - 0.72, -0.13, p=0.004) and MAP (SMD -0.78, 95% CI: -1.09, -0.48, p<0.001) in fentanyl group were significantly lower compared with placebo group. Conclusion: The present meta-analysis showed that using intravenous fentanyl as a premedication before induction of general anesthesia had adverse effects on neonate Apgar score. However, it had positive effects on preventing adverse consequences of intubation on maternal hemodynamics.

Efficacy of NSAIDs versus radiotherapy for heterotopic ossification prophylaxis following total hip arthroplasty in high-risk patients: a systematic review and meta-analysis

2021 ◽  
pp. 112070002199111
Author(s):  
Jacob Shapira ◽  
Mitchell J Yelton ◽  
Jeffery W Chen ◽  
Philip J Rosinsky ◽  
David R Maldonado ◽  
...  
Keyword(s):  
Systematic Review ◽  
High Risk ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Meta Analysis ◽  
Comparable Efficacy ◽  
Total Hip ◽  
High Risk Patients ◽  
Randomised Control Trials ◽  
Risk Patients

Background: The aims of this systematic review were: (1) to investigate the prophylactic effect of radiotherapy (RT) and NSAIDs in high-risk patients following total hip arthroplasty (THA); and (2) to compare the efficacy of non-selective and COX-II selective NSAIDs in preventing post-THA HO, utilising a meta-analysis of randomised control studies. Methods: The PubMed, Embase, and Cochrane Databases were searched for articles regarding HO following THA in March 2019. Studies were included if they contained data regarding HO incidence after THA or contained data regarding HO prophylaxis comparison of NSAIDs and/or RT in terms of dosage or duration. Results: 24 studies reported on populations that were not at high-risk for HO. These studies reported between 47.3% and 90.4% of their patient populations had no HO formation; between 2.8% and 52.7% had mild formation; and between 0.0% and 10.4% had severe formation. A total of 13 studies reported on populations at high-risk for HO. Studies analysing RT in high-risk patients reported between 28.6% and 97.4% of patients developed no HO formation; between 1.9% and 66.7% developed mild HO formation; and between 0.0% and 11.9% developed severe HO formation. Studies analysing NSAID treatment among high-risk populations reported between 76.6% and 88.9% had no HO formation; between 11.1% and 23.4% had mild HO formation, and between 0.0% and 1.8% had severe HO formation. 9 studies were identified as randomised control trials and subsequently used for meta-analysis. The relative risk for COX-II in developing any HO after THA was not significantly different compared to non-selective NSAIDs (RR 1.00; CI, 0.801–1.256; p = 0.489). Conclusions: NSAIDs prophylaxis for HO may have better efficacy than RT in high-risk patients following THA. Non-selective and COX-II selective NSAIDs have comparable efficacy in preventing HO. Factors such as medical comorbidities and side-effect profile should dictate the prophylaxis recommendation.

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