背景:产后出血发生在所有分娩的10%以上,是孕产妇死亡的主要原因,占全球所有孕产妇死亡的25%。积极管理第三产程是通过预防产后出血降低产妇发病率和死亡率的最重要干预措施。以前,有记录的初级研究存在很大差异,不一致的结果,缺乏全面的研究。因此,本系统综述和荟萃分析旨在评估埃塞俄比亚产科护理提供者积极管理第三产程的患病率和相关因素.
方法:从2010年1月1日至2020年12月24日,使用PubMed,谷歌学者,Hinari,科克伦图书馆,灰色文学使用DerSemonial-Laird随机效应模型估计了第三期分娩实践和相关因素的积极管理的汇总患病率。Stata(版本16.0)用于分析数据。I平方统计量用于评估研究的异质性。漏斗图和Egger检验用于检查发表偏倚。根据研究年份和样本量,进行亚组分析以最大程度地减少下划线异质性。
结果:提取了七百五十篇文章。最后的十项研究包括在这个系统评价中,包括2438名参与者。埃塞俄比亚产科护理提供者积极管理第三产程的总患病率为39.65%(30.86,48.45%)。教育状况(OR=6.11,95CI,1.51-10.72),产科护理培训(OR=3.56,95%CI:2.66,4.45),工作经验(OR=2.17,95CI,0.47,3.87)和第三产程积极管理知识(OR=4.5,95%CI:2.71,6.28)与第三产程积极管理显著相关.
结论:埃塞俄比亚第三产程的积极管理实践较低。这项研究表明,教育状况,接受产科护理培训,AMTSL知识,产科护理提供者的工作经验与积极管理第三产程的做法有关。因此,产科护理专业人员应提高学术水平,知识,和技能,以便为AMTSL提供有用的服务,拯救母亲的生命。所有产科护理提供者都应接受产科护理培训。此外,政府应该提高产科护理专业人员的教育水平。
Post-partum haemorrhage occurs in over 10% of all births and is the leading cause of maternal mortality, accounting for 25% of all maternal deaths worldwide. Active management of the third stage of labor is the most important intervention for reducing maternal morbidity and mortality by preventing postpartum hemorrhage. Previously, documented primary studies had been great discrepancy, inconsistent results, and there is a lack of comprehensive study. Hence, this systematic review and meta-analysis were intended to assess the prevalence and associated factors of the practice of active management of the third stage of labour among obstetric care providers in Ethiopia.
Cross-sectional studies were systematically searched from January 01, 2010, to December 24, 2020, using PubMed, Google Scholar, HINARI, Cochrane Library, and grey literature. The pooled prevalence of active management of the third stage of labour practice and associated factors was estimated using DerSemonial-Laird Random Effect Model. Stata (version 16.0) was used to analyze the data. The I-squared statistic was used to assess the studies\' heterogeneity. A funnel plot and Egger\'s test were used to check for publication bias. A subgroup analysis was performed to minimize the underline heterogeneity depending on the study years and the sample sizes.
Seven hundred fifty articles were extracted. The final ten studies were included in this systematic review, including 2438 participants. The pooled prevalence of practices of active management of the third stage of labour among obstetric care providers in Ethiopia was 39.65% (30.86, 48.45%). Educational status (OR = 6.11, 95%CI, 1.51-10.72), obstetric care training (OR = 3.56, 95% CI: 2.66, 4.45), work experience (OR = 2.17, 95%CI, 0.47, 3.87) and knowledge of active management of the third stage of labour (OR = 4.5, 95% CI: 2.71, 6.28) were significantly associated with active management of the third stage of labour practices.
The practice of active management of the third stage of labour in Ethiopia was low. This study showed that educational status, taking obstetric care training, knowledge of AMTSL, and work experience of obstetric care providers were associated with of practices of active management of the third stage of labour. Therefore, obstetric care professionals should improve their academic level, knowledge, and skills in order to provide useful service to AMTSL and save mothers\' lives. All obstetric care providers should get obstetric care training. Furthermore, the government should increase obstetric care professionals\' educational level.