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. 2022 Sep 22:3:948288.
doi: 10.3389/fgwh.2022.948288. eCollection 2022.

Prevalence, indications, and outcomes of operative vaginal deliveries among mothers who gave birth in Ethiopia: A systematic review and meta-analysis

Bikila Balis  1 , Adera Debella  1 , Indeshaw Ketema  1 , Bajrond Eshetu  1 , Ebisa Zerihun  2 , Alemayehu Deressa Wayesa  3 , Sisay Habte  1 , Adisu Alemu  3 , Habtamu Bekele  1
Affiliations

Prevalence, indications, and outcomes of operative vaginal deliveries among mothers who gave birth in Ethiopia: A systematic review and meta-analysis

Bikila Balis et al. Front Glob Womens Health. .

Abstract

Background: Operative vaginal deliveries represent an alternative to address problems during the second stage of labor. Clinicians have access to two different instruments obstetrics forceps and vacuum which should be conducted with indication. Understanding the pooled prevalence of operative vaginal deliveries, its indications, and outcomes would help in adopting suitable measures to reduce operative vaginal deliveries-related maternal and neonatal complications. Therefore, this systematic review and meta-analysis aimed to determine the prevalence, indications, and outcomes of operative vaginal deliveries among mothers who gave birth in Ethiopia.

Methods: A literature search was done through databases such as PubMed, SCOPUS, Web of Sciences, CAB Abstract, and CINHAL (EBSCO) to search studies that have been conducted in Ethiopia. Relevant sources were consulted to retrieve unpublished studies. Original observational studies that reported the prevalence, indication and outcomes of operative vaginal deliveries conducted in the English language were identified and screened. Studies were independently assessed for inclusion, data extraction, and risk of bias.

Results: Twelve studies were reviewed. The overall pooled prevalence of operative vaginal delivery among mothers who gave birth in Ethiopia was 10% (95% CI: 8 to 13) with I 2 = 98.82% and a p-value ≤ 0.001. Fetal distress, prolonged labor, and maternal exhaustion were the most common feto-maternal indications of OVDs whereas; neonatal death, poor Apgar score, admission to neonatal intensive care unit, perianal tear, and postpartum hemorrhage were complications that occur following the operative vaginal deliveries in Ethiopia.

Conclusion: This systematic review and meta-analysis showed one out of 10 mothers undergo operative vaginal deliveries. Almost all feto-maternal complications that arise following operative vaginal deliveries were preventable. Thus, concerned stakeholders should encourage quality OVDs practice by avoiding unnecessary indications and scaling up the skill of health professionals through special training.

Systematic review registration: http://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022311432.

Keywords: instrumental deliveries; meta-analysis; obstetrics forceps; operative vaginal deliveries; systematic review; vacuum extractor.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
PRISMA statement presentation for systematic review and meta-analysis of OVDs, its indication, and outcomes among mothers who give birth in Ethiopia, 2022. n, number of studies included at each level.
Figure 2
Figure 2
Forest plot of the pooled prevalence of operative vaginal deliveries among mothers who gave birth in Ethiopia, 2022.
Figure 3
Figure 3
Funnel plot for pooled prevalence of operative vaginal deliveries among mothers in Ethiopia, 2022.
Figure 4
Figure 4
Subgroup analysis of prevalence of operative vaginal deliveries based on region (area) among mothers who gave birth in Ethiopia, 2022.
Figure 5
Figure 5
Subgroup analysis based on year of publication for operative vaginal deliveries among mothers who gave birth in Ethiopia, 2022.
Figure 6
Figure 6
Subgroup analysis based on sample size for prevalence of operative vaginal deliveries among mothers who gave birth in Ethiopia, 2022.
See this image and copyright information in PMC

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