scholarly journals Sonographic lower uterine segment thickness after prior cesarean section to predict uterine rupture: A systematic review and meta‐analysis

2019 ◽  
Vol 98 (7) ◽  
pp. 830-841 ◽  
Author(s):  
Brenna E. Swift ◽  
Prakesh S. Shah ◽  
Dan Farine
Keyword(s):  
Systematic Review ◽  
Cesarean Section ◽  
Uterine Rupture ◽  
Meta Analysis ◽  
Lower Uterine Segment ◽  
Prior Cesarean Section

scholarly journals Incidence of uterine rupture and associated factors in Ethiopia: A systematic review and Meta-analysis

2020 ◽  
Author(s):  
Asteray Assmie Ayenew ◽  
Azezu Asres Nigussie ◽  
Biruk Ferede Zewdu
Keyword(s):  
Systematic Review ◽  
Cesarean Section ◽  
Uterine Rupture ◽  
Associated Factors ◽  
Meta Analysis ◽  
Morbidity And Mortality ◽  
Cochrane Library ◽  
Prolonged Labour ◽  
Obstructed Labour ◽  
Life Threatening

Abstract Background: Globally, maternal morbidity and mortality a major public health challenge. Uterine rupture is a life-threatening obstetrical emergency with life-threatening complications for both the mother and her infant. In developing countries, it is the leading cause of maternal and fetal morbidity and mortality. Therefore, this systematic review and meta-analysis aimed to assess the incidence of uterine rupture and its associated factors among mothers managed for obstetric cases in Ethiopia.Method: for this review, we used the standard PRISMA checklist guideline. Different online databases were used for the review: PubMed, Google Scholar, EMBASE, Cochrane Library, HINARI, WHO Afro Library Databases, and African Online Journals. Based on the adapted PICO principles, different search terms were applied to achieve and access all the essential articles. This search included all published and unpublished observational studies written only in English language and conducted in Ethiopia. Microsoft Excel 16 was used for data entrance, and Stata version 11.0 (Stata Corporation, College Station, Texas, USA) used for data analysis.Result: A total of 21 studies with 33,303 mothers managed for obstetric cases were included. The pooled incidence of uterine rupture among mothers managed for obstetric cases in Ethiopia was 3.25% (95%CI: 2.6–3.89, I2=97.4%, P<0.001). Rural residency (adjusted odds ratio (AOR):5.44; 95% confidence interval (CI): 95%CI: 3.17–9.34, I2 =59.5%, P=0.03), grand multiparty (AOR = 2.38; 95%CI: 1.32–4.29, I2=0.0%, p=0.002), not having antenatal care (AOR =4.05(; 95% CI: 1.90–8.64 I2=89.4%, P<0.001), having previous cesarean section scar (AOR =7.10; 95% CI: 5.40–9.34, I2=26.3%, P=0.254), having Prolonged labour (AOR=6.71; 95%CI: 4.04–11.15, I2=84.6%, P<0.001), having obstructed labour (AOR=7.22; 95%CI: 2.86–18.28, I2=97.4%, P<0.001), no partograph utilization for labour monitoring (AOR=3.43; 95%CI: 1.62–7.29, I2=66.6%, P=0.05) were the determinant factors for the incidence of uterine rupture in Ethiopia.Conclusion: This systematic review and meta-analysis showed that the incidence of uterine rupture was high in Ethiopia. Being from the rural area, prolonged labour, having cesarean section scar, not using partograph for labour monitoring, not having ante natal care, and obstructed labour increased the risk of uterine rupture.

The prevalence of uterine rupture and associated factors in Ethiopia: A systematic review and Meta – analysis

2020 ◽  
Author(s):  
Asteray Assmie Ayenew ◽  
Azezu Asres Nigussie ◽  
Biruk Ferede Zewdu
Keyword(s):  
Systematic Review ◽  
Cesarean Section ◽  
Uterine Rupture ◽  
Associated Factors ◽  
Meta Analysis ◽  
Random Effect Model ◽  
Cochrane Library ◽  
Prolonged Labour ◽  
Obstructed Labour ◽  
Grand Multiparity

Abstract Background Globally, maternal morbidity and mortality a major public health challenge. Uterine rupture is a life-threatening obstetrical emergency with serious undesired complications for both the mother and her infant. Uterine rupture is the leading cause of maternal and fetal death in developing countries. Therefore, the aim of this systematic review and meta-analysis was to assess the prevalence of uterine rupture and its associated factors in Ethiopia. Method: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed. The databases used were; PubMed, Google scholar, Cochrane Library, African Journals Online, Ethiopian's university research repository online library, and manual searching. The search was further limited to studies conducted in Ethiopia and reported in English. Two authors independently extracted all necessary data using a standardized data extraction format. STATA 11 software was used to analyze the data. The Cochrane Q and I2 test were used to assess the heterogeneity of studies. The pooled estimate prevalence and the odds ratios with 95% confidence intervals were computed by a random effect model. Result: A total of 16 studies were included in this meta-analysis with a sample size of 10,550. The national pooled prevalence of uterine rupture was 14.74%. The pooled adjusted odds ratio (AOR) of uterine rupture for prolonged labour(>24hours) was 4.3 (95% CI=2.57,7.19), not having antenatal care during pregnancy was 3.71(95%CI=2.26,6.08),grand multiparity was 1.99(95%CI=1.04,3.81),rural residency was 4.17 (95%CI=1.72,10.12),having cesarean section scar was 8.52 (95%CI: 4.98,14.59),not using partograph during labour was 3.43(1.62,7.29), and obstructed labour was 8.78(95%CI:3.38,22.8). Conclusion: This systematic review and meta-analysis showed that uterine rupture was high in Ethiopia. Being from the rural residence, prolonged labour(>24hours) , not having ante natal care , grand multiparity, having cesarean section scar , not using partograph during labour, and obstructed labour increased the risk of uterine rupture.

scholarly journals Prevalence and determinants of uterine rupture in Ethiopia: a systematic review and meta-analysis

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Addisu Alehegn Alemu ◽  
Mezinew Sintayehu Bitew ◽  
Kelemu Abebe Gelaw ◽  
Liknaw Bewket Zeleke ◽  
Getachew Mullu Kassa
Keyword(s):  
Systematic Review ◽  
Cesarean Section ◽  
Uterine Rupture ◽  
Meta Analysis ◽  
Health Concern ◽  
Cochrane Library ◽  
Previous Cesarean Section ◽  
Urban Residence ◽  
Obstructed Labor ◽  
Previous Cesarean

Abstract Uterine rupture is a serious public health concern that causes high maternal and perinatal morbidity and mortality in the developing world. Few of the studies conducted in Ethiopia show a high discrepancy in the prevalence of uterine rupture, which ranges between 1.6 and 16.7%. There also lacks a national study on this issue in Ethiopia. This systematic and meta-analysis, therefore, was conducted to assess the prevalence and determinants of uterine rupture in Ethiopia. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for systematic review and meta-analysis of studies. All observational published studies were retrieved using relevant search terms in Google scholar, African Journals Online, CINHAL, HINARI, Science Direct, Cochrane Library, EMBASE and PubMed (Medline) databases. Newcastle–Ottawa assessment checklist for observational studies was used for critical appraisal of the included articles. The meta-analysis was done with STATA version 14 software. The I2 test statistics were used to assess heterogeneity among included studies, and publication bias was assessed using Begg's and Egger's tests. Odds ratio (OR) with a 95% confidence interval (CI) was presented using forest plots. A total of twelve studies were included in this study. The pooled prevalence of uterine rupture was 3.98% (95% CI 3.02, 4.95). The highest (7.82%) and lowest (1.53%) prevalence were identified in Amhara and Southern Nations, Nationality and Peoples Region (SNNPR), respectively. Determinants of uterine rupture were urban residence (OR = 0.15 (95% CI 0.09, 0.23)), primipara (OR = 0.12 (95% CI 0.06, 0.27)), previous cesarean section (OR = 3.23 (95% CI 2.12, 4.92)), obstructed labor(OR = 12.21 (95% CI 6.01, 24.82)), and partograph utilization (OR = 0.12 (95% CI 0.09, 0.17)). Almost one in twenty-five mothers had uterine rupture in Ethiopia. Urban residence, primiparity, previous cesarean section, obstructed labor and partograph utilization were significantly associated with uterine rupture. Therefore, intervention programs should address the identified factors to reduce the prevalence of uterine rupture.

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.

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

2021 ◽  
pp. 100360
Author(s):  
Chiara Cerra ◽  
Roberta Morelli ◽  
Daniele Di Mascio ◽  
Danilo Buca ◽  
Francesca Di Sebastiano ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cesarean Section ◽  
Meta Analysis ◽  
Maternal Outcomes
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