scholarly journals Perioperative Complications of Hysterectomy After a Previous Cesarean Section: A Systematic Review and Meta-Analysis

2019 ◽  
Vol Volume 11 ◽  
pp. 1089-1098
Author(s):  
Siwanon Rattanakanokchai ◽  
Chumnan Kietpeerakool ◽  
Jatupol Srisomboon ◽  
Nampet Jampathong ◽  
Porjai Pattanittum ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cesarean Section ◽  
Perioperative Complications ◽  
Meta Analysis ◽  
Previous Cesarean Section ◽  
Previous Cesarean

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.

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.

scholarly journals Outcomes of Oblique Lateral Interbody Fusion for Adult Spinal Deformity: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 219256822097914
Author(s):  
Lei Zhu ◽  
Jun-Wu Wang ◽  
Liang Zhang ◽  
Xin-Min Feng
Keyword(s):  
Systematic Review ◽  
Lumbar Lordosis ◽  
Interbody Fusion ◽  
Perioperative Complications ◽  
Adult Spinal Deformity ◽  
Meta Analysis ◽  
Fusion Rate ◽  
The Mean ◽  
Oblique Lateral Interbody Fusion ◽  
Lateral Interbody

Study Design: A systematic review and meta-analysis. Objectives: To evaluate clinical and radiographic outcomes, and perioperative complications of oblique lateral interbody fusion (OLIF) for adult spinal deformity (ASD). Methods: We performed a systematic review and meta-analysis of related studies reporting outcomes of OLIF for ASD. The clinical outcomes were assessed by visual analogue scale (VAS) and Oswestry Disability Index (ODI). The radiographic parameters were evaluated by sagittal vertical axis (SVA), pelvic tilt (PT), sacral slope (SS), thoracic kyphosis (TK), lumbar lordosis (LL), pelvic incidence-lumbar lordosis (PI-LL), Cobb angle and fusion rate. A random effects model and 95% confidence intervals (CI) were performed to investigate the results. Results: A total of 16 studies involving 519 patients were included in the present study. The mean difference of VAS-back score, VAS-leg score and ODI score before and after surgery was 5.1, 5.0 and 32.3 respectively. The mean correction of LL was 20.6°, with an average of 6.9° per level and the mean correction of Cobb was 16.4°, with an average of 4.7° per level. The mean correction of SVA, PT, SS, TK and PI-LL was 59.3 mm, 11.7°, 6.9°, 9.4° and 20.6° respectively. The mean fusion rate was 94.1%. The incidence of intraoperative and postoperative complications was 4.9% and 29.6% respectively. Conclusions: OLIF is an effective and safe surgery method in the treatment of mild or moderate ASD and it has advantages in less intraoperative blood loss and lower perioperative complications.

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