Maternal outcomes of cesarean section performed at early gestational ages: a systematic review and meta-analysis

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.

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Transversus abdominis plane block versus wound infiltration for post‐cesarean section analgesia: A systematic review and meta‐analysis of randomized controlled trials

International Journal of Gynecology & Obstetrics ◽

10.1002/ijgo.13563 ◽

2020 ◽

Author(s):

Gaetano Riemma ◽

Antonio Schiattarella ◽

Stefano Cianci ◽

Marco La Verde ◽

Maddalena Morlando ◽

...

Keyword(s):

Systematic Review ◽

Cesarean Section ◽

Randomized Controlled Trials ◽

Meta Analysis ◽

Transversus Abdominis Plane Block ◽

Transversus Abdominis ◽

Controlled Trials ◽

Transversus Abdominis Plane ◽

Wound Infiltration ◽

Randomized Controlled

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The Impact of Diagnostic Criteria for Gestational Diabetes Mellitus on Adverse Maternal Outcomes: A Systematic Review and Meta-Analysis

Journal of Clinical Medicine ◽

10.3390/jcm10040666 ◽

2021 ◽

Vol 10 (4) ◽

pp. 666

Author(s):

Fahimeh Ramezani Tehrani ◽

Marzieh Saei Ghare Naz ◽

Razieh Bidhendi Yarandi ◽

Samira Behboudi-Gandevani

Keyword(s):

Systematic Review ◽

Gestational Diabetes ◽

Pregnant Women ◽

Diagnostic Criteria ◽

Meta Analysis ◽

Population Based ◽

Maternal Outcomes ◽

Care Providers ◽

Iadpsg Criteria ◽

The Impact

This systematic review and meta-analysis aimed to examine the impact of different gestational-diabetes (GDM) diagnostic-criteria on the risk of adverse-maternal-outcomes. The search process encompassed PubMed (Medline), Scopus, and Web of Science databases to retrieve original, population-based studies with the universal GDM screening approach, published in English language and with a focus on adverse-maternal-outcomes up to January 2020. According to GDM diagnostic criteria, the studies were classified into seven groups. A total of 49 population-based studies consisting of 1409018 pregnant women with GDM and 7,667,546 non-GDM counterparts were selected for data analysis and knowledge synthesis. Accordingly, the risk of adverse-maternal-outcomes including primary-cesarean, induction of labor, maternal-hemorrhage, and pregnancy-related-hypertension, overall, regardless of GDM diagnostic-criteria and in all diagnostic-criteria subgroups were significantly higher than non-GDM counterparts. However, in meta-regression, the increased risk was not influenced by the GDM diagnostic-classification and the magnitude of the risks among patients, using the IADPSG criteria-classification as the most strict-criteria, was similar to other criteria. In conclusion, a reduction in the diagnostic-threshold increased the prevalence of GDM, but the risk of adverse-maternal-outcome was not different among those women who were diagnosed through more or less intensive strategies. Our review findings can empower health-care-providers to select the most cost-effective approach for the screening of GDM among pregnant women.

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Reproductive and pregnancy outcomes following embryo transfer in women with previous cesarean section: A systematic review and meta‐analysis

Acta Obstetricia Et Gynecologica Scandinavica ◽

10.1111/aogs.14239 ◽

2021 ◽

Author(s):

Gaetano Riemma ◽

Pasquale De Franciscis ◽

Marco Torella ◽

Giuliana Narciso ◽

Marco La Verde ◽

...

Keyword(s):

Systematic Review ◽

Cesarean Section ◽

Embryo Transfer ◽

Pregnancy Outcomes ◽

Meta Analysis ◽

Previous Cesarean Section ◽

Previous Cesarean

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Changing gloves during cesarean section for prevention of postoperative infections: a systematic review and meta-analysis

Scientific Reports ◽

10.1038/s41598-021-84259-w ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Siwanon Rattanakanokchai ◽

Nuntasiri Eamudomkarn ◽

Nampet Jampathong ◽

Bao-Yen Luong-Thanh ◽

Chumnan Kietpeerakool

Keyword(s):

Systematic Review ◽

Cesarean Section ◽

Meta Analysis ◽

Postoperative Infections ◽

Quality Of Evidence ◽

Randomized Controlled ◽

Incisional Surgical Site Infection ◽

Grade Approach ◽

Febrile Morbidity

AbstractThis systematic review and meta-analysis was conducted to assess associations between changing gloves during cesarean section (CS) and postoperative infection. A literature search was conducted using the major electronic databases MEDLINE, Scopus, ISI Web of Science, PubMed, CINAHL, and CENTRAL from their inception to September 2020. Randomized controlled trials (RCTs) comparing glove change during CS to no glove change were included. Outcomes of interest were endometritis, febrile morbidity, and incisional surgical site infection (SSI). GRADE approach was applied to assess the quality of evidence. Ten reports of six studies involving 1707 participants were included in the analyses. Glove change was associated with a reduction in the risk of incisional SSI following CS (pooled RR 0.49, 95% CI 0.30, 0.78; moderate quality of evidence). Compared to no glove change, glove change during CS did not reduce the risks of endometritis (pooled RR 1.00, 95% CI 0.80, 1.24; low quality of evidence) or febrile morbidity (pooled RR 0.85, 95% CI 0.43, 1.71; very low quality of evidence). Changing gloves during CS was associated with a decreased risk of incisional SSI. The risks of postoperative endometritis and febrile morbidity were not altered by changing gloves.

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