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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...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer US
2019
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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. |
format | Online Article Text |
id | pubmed-6606670 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Springer US |
record_format | MEDLINE/PubMed |
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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