Alòs-Pereñíguez Silvia, O'Malley Deirdre, Daly Deirdre
School of Nursing & Midwifery, Faculty of Health Sciences, Trinity College Dublin, Dublin, D02 T283, Ireland.
Nursing, Midwifery & Health Studies, Dundalk Institute of Technology, Dundalk, A91 K584, Ireland.
Midwifery. 2023 Jan;116:103512. doi: 10.1016/j.midw.2022.103512. Epub 2022 Oct 8.
To explore and synthesise women's views and experiences of augmentation of labour with synthetic oxytocin infusion.
A qualitative evidence synthesis was conducted. The SPIDER acronym was used to develop the search terms and determine the inclusion criteria. Six bibliographic databases: MEDLINE, CINAHL, EMBASE, PsycINFO, Maternity and Infant Care and Web of Science Core Collection were searched in October 2021. Grey literature sources, EThOS, DART-Europe, and the World Health Organization's Clinical Trials Registry were searched, and reference lists of included studies were reviewed. Methodological quality of included studies was assessed using the Evidence for Policy and Practice Information and Co-ordinating (EPPI) Centre assessment tool. Data were synthesised thematically. The confidence of each review finding was assessed using the Grading of Recommendations Assessment, Development and Evaluation-Confidence in the Evidence from Reviews of Qualitative research (GRADE-CERQual). Research ethical approval was not required.
Women of any age, parity, and cultural background who underwent augmentation of labour with synthetic oxytocin infusion were included.
A total of 9306 citations were retrieved. Twenty-five studies conducted across 14 countries met the inclusion criteria and contributed data. Three principal analytical themes emerged: feeling stuck; past and present shaping the future; and cause and effect of augmentation of labour. The decision to augment women's labour was often performed without their informed consent. Women's views and experiences of augmentation of labour were shaped according to their knowledge, beliefs and support received during labour. Irrespective of the context, women consistently associated augmentation of labour with pain.
Clinical guidelines on augmentation of labour need to be informed by research that includes women's views and experiences as a main outcome. Future research exploring the experience of augmentation of labour rather than the experience of labour dystocia would be beneficial. Increasing women's awareness and knowledge of augmentation of labour may help to ensure that their informed consent is obtained. Healthcare providers should discuss the effects, side effects and implications of augmentation of labour with women, ideally before labour.
探讨并综合分析女性对静脉输注合成缩宫素加强宫缩的看法和经历。
进行了一项定性证据综合分析。使用SPIDER首字母缩写词来制定检索词并确定纳入标准。于2021年10月检索了六个文献数据库：医学期刊数据库（MEDLINE）、护理学与健康照护数据库（CINAHL）、荷兰医学文摘数据库（EMBASE）、心理学文摘数据库（PsycINFO）、母婴护理数据库以及科学引文索引核心合集（Web of Science Core Collection）。检索了灰色文献来源、英国高等教育机构文献库（EThOS）、欧洲文献传递服务（DART-Europe）以及世界卫生组织临床试验注册库，并对纳入研究的参考文献列表进行了审查。使用政策与实践信息及协调证据中心（EPPI中心）评估工具对纳入研究的方法学质量进行评估。对数据进行了主题综合分析。使用推荐分级评估、制定与评价——定性研究综述证据的可信度（GRADE-CERQual）对每项综述结果的可信度进行评估。无需研究伦理批准。
纳入了所有年龄、胎次和文化背景且接受过静脉输注合成缩宫素加强宫缩的女性。
共检索到9306条引文。来自14个国家的25项研究符合纳入标准并提供了数据。出现了三个主要分析主题：感觉被困住；过去与现在塑造未来；以及加强宫缩的因果关系。加强女性宫缩的决定往往在未获得其知情同意的情况下做出。女性对加强宫缩的看法和经历是根据她们在分娩期间获得的知识、信念和支持而形成的。无论背景如何，女性始终将加强宫缩与疼痛联系在一起。
关于加强宫缩的临床指南应以将女性的看法和经历作为主要结果的研究为依据。未来探索加强宫缩经历而非产程异常经历的研究将是有益的。提高女性对加强宫缩的认识和了解可能有助于确保获得她们的知情同意。医疗保健提供者应与女性讨论加强宫缩的效果、副作用及影响，最好在分娩前进行。
