Department of Midwifery, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
Department of Midwifery, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
PLoS One. 2023 Apr 20;18(4):e0281343. doi: 10.1371/journal.pone.0281343. eCollection 2023.
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.
产后出血发生在超过 10%的分娩中，是产妇死亡的主要原因，占全球产妇死亡的 25%。积极管理第三产程是预防产后出血、降低产妇发病率和死亡率的最重要干预措施。此前，已发表的原始研究存在很大差异，结果不一致，缺乏全面的研究。因此，本系统评价和荟萃分析旨在评估埃塞俄比亚产科医务人员中积极管理第三产程实践的流行率和相关因素。
从 2010 年 1 月 1 日至 2020 年 12 月 24 日，使用 PubMed、Google Scholar、HINARI、Cochrane Library 和灰色文献系统地搜索了横断面研究。使用 DerSimonian-Laird 随机效应模型估计积极管理第三产程实践的汇总流行率和相关因素。使用 Stata（版本 16.0）分析数据。使用 I 平方统计量评估研究的异质性。使用漏斗图和 Egger 检验检查发表偏倚。根据研究年限和样本量进行亚组分析以最小化潜在的异质性。
共提取了 750 篇文章。最终纳入了 10 项系统评价，共纳入了 2438 名参与者。埃塞俄比亚产科医务人员积极管理第三产程实践的综合流行率为 39.65%（30.86%，48.45%）。教育程度（OR=6.11，95%CI，1.51-10.72）、产科培训（OR=3.56，95%CI：2.66-4.45）、工作经验（OR=2.17，95%CI：0.47-3.87）和积极管理第三产程知识（OR=4.5，95%CI：2.71-6.28）与积极管理第三产程实践显著相关。
埃塞俄比亚积极管理第三产程的实践率较低。本研究表明，教育程度、接受产科培训、AMTSL 知识和产科医务人员工作经验与积极管理第三产程实践有关。因此，产科医务人员应提高学术水平、知识和技能，为 AMTSL 提供有用的服务，挽救母亲的生命。所有产科医务人员都应接受产科培训。此外，政府应提高产科医务人员的教育水平。
