Prevalence, indications and fetal outcomes of operative vaginal delivery in Sub-Saharan Africa, systematic review, and meta-analysis

This systematic review and meta-analysis is intended to assess the prevalence, indications, and fetal outcome of operative vaginal delivery in sub-Saharan Africa. In this study, 17 studies with a total population of 190,900 were included in both systematic review and meta-analysis. Search for releva...

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Published in:BMC women's health 2023-03, Vol.23 (1), p.95-9, Article 95
Main Authors: Mebratu, Andualem, Ahmed, Abbas, Zemeskel, Addisu Getnet, Alemu, Asrat, Temesgen, Tesfaye, Molla, Wondwosen, Figa, Zerihun
Format: Article
Language:English
Subjects:
Africa South of the Sahara - epidemiology
Analysis
Apgar score
Birth injuries
Capacity development
Cervix
Childbirth & labor
Delivery, Obstetric
Disease
Distribution
Eclampsia
Episiotomy
Female
Fetal outcomes
Fetuses
Forceps
Heart rate
Heterogeneity
Humans
Hypertension
Indications
Infant
Instrumental delivery
Intensive care
Meta-analysis
Natural childbirth
Obstetrics
Operative vaginal delivery
Patient outcomes
Preeclampsia
Pregnancy
Prenatal Care
Prevalence
Prevalence studies (Epidemiology)
Services
Software
Stillbirth
Systematic review
Vacuum
Vagina
Womens health
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container_title BMC women's health
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Ahmed, Abbas
Zemeskel, Addisu Getnet
Alemu, Asrat
Temesgen, Tesfaye
Molla, Wondwosen
Figa, Zerihun
description This systematic review and meta-analysis is intended to assess the prevalence, indications, and fetal outcome of operative vaginal delivery in sub-Saharan Africa. In this study, 17 studies with a total population of 190,900 were included in both systematic review and meta-analysis. Search for relevant articles was done by using international online databases (like Google Scholar, PubMed, HINARI, EMBASE, Web of Science, and African journals) and online repositories of Universities in Africa. The JOANNA Briggs Institute standard data extraction format was used to extract and appraise high-quality articles before being included in this study. The Cochran Q and I statistical tests were used to test the heterogeneity of the studies. The publication bias was tested by a Funnel plot and Egger's test. The overall pooled prevalence, indications, and fetal outcome of operative vaginal delivery along a 95% CI using forest plots and tables. The overall pooled prevalence of operative vaginal delivery in sub-Saharan Africa was 7.98% (95% CI; 5.03-10.65; I2 = 99.9%, P 
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In this study, 17 studies with a total population of 190,900 were included in both systematic review and meta-analysis. Search for relevant articles was done by using international online databases (like Google Scholar, PubMed, HINARI, EMBASE, Web of Science, and African journals) and online repositories of Universities in Africa. The JOANNA Briggs Institute standard data extraction format was used to extract and appraise high-quality articles before being included in this study. The Cochran Q and I statistical tests were used to test the heterogeneity of the studies. The publication bias was tested by a Funnel plot and Egger's test. The overall pooled prevalence, indications, and fetal outcome of operative vaginal delivery along a 95% CI using forest plots and tables. The overall pooled prevalence of operative vaginal delivery in sub-Saharan Africa was 7.98% (95% CI; 5.03-10.65; I2 = 99.9%, P &lt; 0.001). The indications of operative vaginal delivery in sub-Saharan African countries include the prolonged second stage of labor 32.81%, non-reassuring fetal heart rate 37.35%, maternal exhaustion 24.81%, big baby 22.37%, maternal cardiac problems 8.75%, and preeclampsia/eclampsia 2.4%. Regarding the fetal outcome, favourable fetal outcomes were 55% (95% CI: 26.04, 84.44), p =  &lt; 0.56, I2: 99.9%). From those births with unfavourable outcomes, the need for the resuscitation of new-born was highest 28.79% followed by poor 5th minute Apgar score, NICU admission, and fresh stillbirth, 19.92, 18.8, and 3.59% respectively. The overall prevalence of operative vaginal delivery (OVD) in sub-Saharan Africa was slightly higher compared to other countries. 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The indications of operative vaginal delivery in sub-Saharan African countries include the prolonged second stage of labor 32.81%, non-reassuring fetal heart rate 37.35%, maternal exhaustion 24.81%, big baby 22.37%, maternal cardiac problems 8.75%, and preeclampsia/eclampsia 2.4%. Regarding the fetal outcome, favourable fetal outcomes were 55% (95% CI: 26.04, 84.44), p =  &lt; 0.56, I2: 99.9%). From those births with unfavourable outcomes, the need for the resuscitation of new-born was highest 28.79% followed by poor 5th minute Apgar score, NICU admission, and fresh stillbirth, 19.92, 18.8, and 3.59% respectively. The overall prevalence of operative vaginal delivery (OVD) in sub-Saharan Africa was slightly higher compared to other countries. 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subjects Africa South of the Sahara - epidemiology
Analysis
Apgar score
Birth injuries
Capacity development
Cervix
Childbirth & labor
Delivery, Obstetric
Disease
Distribution
Eclampsia
Episiotomy
Female
Fetal outcomes
Fetuses
Forceps
Heart rate
Heterogeneity
Humans
Hypertension
Indications
Infant
Instrumental delivery
Intensive care
Meta-analysis
Natural childbirth
Obstetrics
Operative vaginal delivery
Patient outcomes
Preeclampsia
Pregnancy
Prenatal Care
Prevalence
Prevalence studies (Epidemiology)
Services
Software
Stillbirth
Systematic review
Vacuum
Vagina
Womens health
title Prevalence, indications and fetal outcomes of operative vaginal delivery in Sub-Saharan Africa, systematic review, and meta-analysis
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