干旱区生态环境知识资源中心(Arid): Severe perineal lacerations in induction of labor versus expectant management: A systematic review and meta-analysis of randomized controlled trials

Arid

DOI	10.1016/j.ajogmf.2024.101407
	Severe perineal lacerations in induction of labor versus expectant management: A systematic review and meta-analysis of randomized controlled trials
	Sigdel, Manisha; Burd, Julia; Walker, Kate F.; Wennerholm, Ulla-Britt; Berghella, Vincenzo
通讯作者	Berghella, V
来源期刊	AMERICAN JOURNAL OF OBSTETRICS & GYNECOLOGY MFM
ISSN	2589-9333
出版年	2024
卷号	6 期号:8
英文摘要	OBJECTIVE: This study aimed to evaluate if induction of labor (IOL) is associated with an increased risk of severe perineal laceration. DATA SOURCES: A systematic search was conducted in MEDLINE, Ovid, Scopus, ClinicalTrials. gov, Cochrane Central Register of Controlled Trials, and CINHAL using a combination of keywords and text words related to induction of labor, severe perineal laceration, third-degree laceration, fourth-degree laceration, and OASIS from inception of each database until January 2023. STUDY ELIGIBILITY CRITERIA: We included all randomized controlled trials (RCTs) comparing IOL to expectant management of a singleton, cephalic pregnancy at term gestation that reported rates of severe perineal laceration. STUDY APPRAISAL AND SYNTHESIS AND METHODS: The primary outcome of interest was severe perineal laceration, de fined as 3rd- or 4th-degree perineal lacerations. We conducted meta-analyses using the random effects model of DerSimonian and Laird to determine the relative risks (RR) or mean differences with 95% con fidence intervals (CIs). Bias was assessed using guidelines established by Cochrane Handbook for Systematic Reviews of Interventions. RESULTS: A total of 11,187 unique records were screened and ultimately eight RCTs were included, involving 13,297 patients. There was no statistically signi ficant difference in the incidence of severe perineal lacerations between the IOL and expectant management groups (209/6655 [3.1%] vs 202/6641 [3.0%]; RR 1.03, 95% CI 0.85, 1.26). There was a statistically signi ficant decrease in the rate of cesarean birth (1090/6655 [16.4%] vs 1230/6641 [18.5%], RR 0.89, 95% CI 0.82, 0.95) and fetal macrosomia (734/2696 [27.2%] vs 964/ 2703 [35.7%]; RR 0.67: 95% CI 0.50, 0.90) in the IOL group. CONCLUSION: There is no signi ficant difference in the risk of severe perineal lacerations between IOL and expectant management in this meta-analysis of RCTs. Furthermore, there is a lower rate of cesarean births in the IOL group, indicating more successful vaginal deliveries with similar rates of severe perineal lacerations. Patients should be counseled that in addition to the known bene fits of induction, there is no increased risk of severe perineal lacerations.
英文关键词	3rd-degree laceration 4th-degree laceration induction of labor OASIS severe perineal laceration vaginal delivery
类型	Review
语种	英语
收录类别	SCI-E
WOS记录号	WOS:001267752900001
WOS关键词	RISK-FACTORS ; DELIVERY
WOS类目	Obstetrics & Gynecology
WOS研究方向	Obstetrics & Gynecology
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/402814
推荐引用方式 GB/T 7714	Sigdel, Manisha,Burd, Julia,Walker, Kate F.,et al. Severe perineal lacerations in induction of labor versus expectant management: A systematic review and meta-analysis of randomized controlled trials[J],2024,6(8).
APA	Sigdel, Manisha,Burd, Julia,Walker, Kate F.,Wennerholm, Ulla-Britt,&Berghella, Vincenzo.(2024).Severe perineal lacerations in induction of labor versus expectant management: A systematic review and meta-analysis of randomized controlled trials.AMERICAN JOURNAL OF OBSTETRICS & GYNECOLOGY MFM,6(8).
MLA	Sigdel, Manisha,et al."Severe perineal lacerations in induction of labor versus expectant management: A systematic review and meta-analysis of randomized controlled trials".AMERICAN JOURNAL OF OBSTETRICS & GYNECOLOGY MFM 6.8(2024).