Postpartum urinary incontinence and birth outcomes as a result of the pushing technique: a systematic review and meta-analysis
INTRODUCTION AND HYPOTHESIS: Directed pushing while using the Valsalva maneuver is shown to lead to bladder neck descent, especially in women with urinary incontinence (UI). There is insufficient evidence about the benefits or adverse effects between the pushing technique during the second stage of...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9206626/ https://www.ncbi.nlm.nih.gov/pubmed/35103823 http://dx.doi.org/10.1007/s00192-021-05058-5 |
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author | Shinozaki, Katsuko Suto, Maiko Ota, Erika Eto, Hiromi Horiuchi, Shigeko |
author_facet | Shinozaki, Katsuko Suto, Maiko Ota, Erika Eto, Hiromi Horiuchi, Shigeko |
author_sort | Shinozaki, Katsuko |
collection | PubMed |
description | INTRODUCTION AND HYPOTHESIS: Directed pushing while using the Valsalva maneuver is shown to lead to bladder neck descent, especially in women with urinary incontinence (UI). There is insufficient evidence about the benefits or adverse effects between the pushing technique during the second stage of labor and urinary incontinence postpartum. The objective of this study was to evaluate the effects of the pushing technique for women during labor on postpartum UI and birth outcomes. METHODS: Scientific databases were searched for studies relating to postpartum urinary incontinence and birth outcomes when the pushing technique was used from 1986 until 2020. RCTs that assessed healthy primiparas who used the pushing technique in the second stage of labor were included. In accordance with Cochrane Handbook guidelines, risk of bias was assessed and meta-analyzed. Certainty of evidence was assessed using the GRADE approach. RESULTS: Seventeen RCTs (4606 primiparas) were included. The change in UI scores from baseline to postpartum was significantly lower as a result of spontaneous pushing (two studies; 867 primiparas; standardized mean difference: SMD –0.18, 95% CI –0.31 to –0.04). Although women were in the recumbent position during the second stage, directed pushing group showed a significantly shorter labor by 21.39 min compared with the spontaneous pushing group: there was no significant difference in the duration of the second stage of labor between groups. CONCLUSIONS: Primiparas who were in the upright position and who experienced spontaneous pushing during the second stage of labor could reduce their UI score from baseline to postpartum. |
format | Online Article Text |
id | pubmed-9206626 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-92066262022-06-20 Postpartum urinary incontinence and birth outcomes as a result of the pushing technique: a systematic review and meta-analysis Shinozaki, Katsuko Suto, Maiko Ota, Erika Eto, Hiromi Horiuchi, Shigeko Int Urogynecol J Review Article INTRODUCTION AND HYPOTHESIS: Directed pushing while using the Valsalva maneuver is shown to lead to bladder neck descent, especially in women with urinary incontinence (UI). There is insufficient evidence about the benefits or adverse effects between the pushing technique during the second stage of labor and urinary incontinence postpartum. The objective of this study was to evaluate the effects of the pushing technique for women during labor on postpartum UI and birth outcomes. METHODS: Scientific databases were searched for studies relating to postpartum urinary incontinence and birth outcomes when the pushing technique was used from 1986 until 2020. RCTs that assessed healthy primiparas who used the pushing technique in the second stage of labor were included. In accordance with Cochrane Handbook guidelines, risk of bias was assessed and meta-analyzed. Certainty of evidence was assessed using the GRADE approach. RESULTS: Seventeen RCTs (4606 primiparas) were included. The change in UI scores from baseline to postpartum was significantly lower as a result of spontaneous pushing (two studies; 867 primiparas; standardized mean difference: SMD –0.18, 95% CI –0.31 to –0.04). Although women were in the recumbent position during the second stage, directed pushing group showed a significantly shorter labor by 21.39 min compared with the spontaneous pushing group: there was no significant difference in the duration of the second stage of labor between groups. CONCLUSIONS: Primiparas who were in the upright position and who experienced spontaneous pushing during the second stage of labor could reduce their UI score from baseline to postpartum. Springer International Publishing 2022-02-01 2022 /pmc/articles/PMC9206626/ /pubmed/35103823 http://dx.doi.org/10.1007/s00192-021-05058-5 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Review Article Shinozaki, Katsuko Suto, Maiko Ota, Erika Eto, Hiromi Horiuchi, Shigeko Postpartum urinary incontinence and birth outcomes as a result of the pushing technique: a systematic review and meta-analysis |
title | Postpartum urinary incontinence and birth outcomes as a result of the pushing technique: a systematic review and meta-analysis |
title_full | Postpartum urinary incontinence and birth outcomes as a result of the pushing technique: a systematic review and meta-analysis |
title_fullStr | Postpartum urinary incontinence and birth outcomes as a result of the pushing technique: a systematic review and meta-analysis |
title_full_unstemmed | Postpartum urinary incontinence and birth outcomes as a result of the pushing technique: a systematic review and meta-analysis |
title_short | Postpartum urinary incontinence and birth outcomes as a result of the pushing technique: a systematic review and meta-analysis |
title_sort | postpartum urinary incontinence and birth outcomes as a result of the pushing technique: a systematic review and meta-analysis |
topic | Review Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9206626/ https://www.ncbi.nlm.nih.gov/pubmed/35103823 http://dx.doi.org/10.1007/s00192-021-05058-5 |
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