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Birth-Related Perineal Trauma in Low- and Middle-Income Countries: A Systematic Review and Meta-analysis

Introduction Birth-related perineal trauma (BPT) is a common consequence of vaginal births. When poorly managed, BPT can result in increased morbidity and mortality due to infections, haemorrhage, and incontinence. This review aims to collect data on rates of BPT in low- and middle-income countries...

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Autores principales: Aguiar, Magda, Farley, Amanda, Hope, Lucy, Amin, Adeela, Shah, Pooja, Manaseki-Holland, Semira
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6606670/
https://www.ncbi.nlm.nih.gov/pubmed/30915627
http://dx.doi.org/10.1007/s10995-019-02732-5
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author Aguiar, Magda
Farley, Amanda
Hope, Lucy
Amin, Adeela
Shah, Pooja
Manaseki-Holland, Semira
author_facet Aguiar, Magda
Farley, Amanda
Hope, Lucy
Amin, Adeela
Shah, Pooja
Manaseki-Holland, Semira
author_sort Aguiar, Magda
collection PubMed
description Introduction Birth-related perineal trauma (BPT) is a common consequence of vaginal births. When poorly managed, BPT can result in increased morbidity and mortality due to infections, haemorrhage, and incontinence. This review aims to collect data on rates of BPT in low- and middle-income countries (LMICs), through a systematic review and meta-analysis. Methods The following databases were searched: Medline, Embase, Latin American and Caribbean Health Sciences Literature (LILACs), and the World Health Organization (WHO) regional databases, from 2004 to 2016. Cross-sectional data on the proportion of vaginal births that resulted in episiotomy, second degree tears or obstetric anal sphincter injuries (OASI) were extracted from studies carried out in LMICs by two independent reviewers. Estimates were meta-analysed using a random effects model; results were presented by type of BPT, parity, and mode of birth. Results Of the 1182 citations reviewed, 74 studies providing data on 334,054 births in 41 countries were included. Five studies reported outcomes of births in the community. In LMICs, the overall rates of BPT were 46% (95% CI 36–55%), 24% (95% CI 17–32%), and 1.4% (95% CI 1.2–1.7%) for episiotomies, second degree tears, and OASI, respectively. Studies were highly heterogeneous with respect to study design and population. The overall reporting quality was inadequate. Discussion Compared to high-income settings, episiotomy rates are high in LMIC medical facilities. There is an urgent need to improve reporting of BPT in LMICs particularly with regards to births taking in community settings. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s10995-019-02732-5) contains supplementary material, which is available to authorized users.
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spelling pubmed-66066702019-07-18 Birth-Related Perineal Trauma in Low- and Middle-Income Countries: A Systematic Review and Meta-analysis Aguiar, Magda Farley, Amanda Hope, Lucy Amin, Adeela Shah, Pooja Manaseki-Holland, Semira Matern Child Health J Article Introduction Birth-related perineal trauma (BPT) is a common consequence of vaginal births. When poorly managed, BPT can result in increased morbidity and mortality due to infections, haemorrhage, and incontinence. This review aims to collect data on rates of BPT in low- and middle-income countries (LMICs), through a systematic review and meta-analysis. Methods The following databases were searched: Medline, Embase, Latin American and Caribbean Health Sciences Literature (LILACs), and the World Health Organization (WHO) regional databases, from 2004 to 2016. Cross-sectional data on the proportion of vaginal births that resulted in episiotomy, second degree tears or obstetric anal sphincter injuries (OASI) were extracted from studies carried out in LMICs by two independent reviewers. Estimates were meta-analysed using a random effects model; results were presented by type of BPT, parity, and mode of birth. Results Of the 1182 citations reviewed, 74 studies providing data on 334,054 births in 41 countries were included. Five studies reported outcomes of births in the community. In LMICs, the overall rates of BPT were 46% (95% CI 36–55%), 24% (95% CI 17–32%), and 1.4% (95% CI 1.2–1.7%) for episiotomies, second degree tears, and OASI, respectively. Studies were highly heterogeneous with respect to study design and population. The overall reporting quality was inadequate. Discussion Compared to high-income settings, episiotomy rates are high in LMIC medical facilities. There is an urgent need to improve reporting of BPT in LMICs particularly with regards to births taking in community settings. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s10995-019-02732-5) contains supplementary material, which is available to authorized users. Springer US 2019-03-26 2019 /pmc/articles/PMC6606670/ /pubmed/30915627 http://dx.doi.org/10.1007/s10995-019-02732-5 Text en © The Author(s) 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Article
Aguiar, Magda
Farley, Amanda
Hope, Lucy
Amin, Adeela
Shah, Pooja
Manaseki-Holland, Semira
Birth-Related Perineal Trauma in Low- and Middle-Income Countries: A Systematic Review and Meta-analysis
title Birth-Related Perineal Trauma in Low- and Middle-Income Countries: A Systematic Review and Meta-analysis
title_full Birth-Related Perineal Trauma in Low- and Middle-Income Countries: A Systematic Review and Meta-analysis
title_fullStr Birth-Related Perineal Trauma in Low- and Middle-Income Countries: A Systematic Review and Meta-analysis
title_full_unstemmed Birth-Related Perineal Trauma in Low- and Middle-Income Countries: A Systematic Review and Meta-analysis
title_short Birth-Related Perineal Trauma in Low- and Middle-Income Countries: A Systematic Review and Meta-analysis
title_sort birth-related perineal trauma in low- and middle-income countries: a systematic review and meta-analysis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6606670/
https://www.ncbi.nlm.nih.gov/pubmed/30915627
http://dx.doi.org/10.1007/s10995-019-02732-5
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