Department of Midwifery, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
School of Midwifery, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia.
Sci Rep. 2023 May 15;13(1):7882. doi: 10.1038/s41598-023-34856-8.
The prevalence of cesarean sections is rising rapidly and is becoming a global issue. Vaginal birth after a cesarean section is one of the safest strategies that can be used to decrease the cesarean section rate. Different fragmented primary studies were done on the success rate of vaginal birth after cesarean section and its associated factors in Ethiopia. However, the findings were controversial and inconclusive. Therefore, this meta-analysis was intended to estimate the pooled success rate of vaginal birth after cesarean section and its associated factors in Ethiopia. Pertinent studies were searched in PubMed, Google Scholar, ScienceDirect, direct open-access journals, and Ethiopian universities' institutional repositories. The data were analyzed using Stata 17. The Newcastle-Ottawa quality assessment tool was used to assess the quality of the studies. I squared statistics and Egger's regression tests were used to assess heterogeneity and publication bias, respectively. A random effects model was selected to estimate the pooled success rate of vaginal birth after cesarean section and its associated factors. The PROSPERO registration number for this review is CRD42023413715. A total of 10 studies were included. The pooled success rate of vaginal birth after a cesarean section was found to be 48.42%. Age less than 30 years (pooled odds ratio (OR) 3.75, 95% CI 1.92, 7.33), previous history of vaginal birth (OR 3.65, 95% CI 2.64, 504), ruptured amniotic membrane at admission (OR 2.87, 95% CI 1.94, 4.26), 4 cm or more cervical dilatation at admission (OR 4, 95% CI 2.33, 6.8), a low station at admission (OR 5.07, 95% CI 2.08, 12.34), and no history of stillbirth (OR 4.93, 95% CI 1.82, 13.36) were significantly associated with successful vaginal birth after cesarean section. In conclusion, the pooled success rate of vaginal birth after a cesarean section was low in Ethiopia. Therefore, the Ministry of Health should consider those identified factors and revise the management guidelines and eligibility criteria for a trial of labor after a cesarean section.
剖宫产的流行率迅速上升，成为一个全球性问题。剖宫产后阴道分娩是降低剖宫产率的最安全策略之一。在埃塞俄比亚，不同的零散的原始研究已经针对剖宫产后阴道分娩的成功率及其相关因素进行了研究。然而，研究结果存在争议且没有定论。因此，本荟萃分析旨在估计埃塞俄比亚剖宫产后阴道分娩的成功率及其相关因素。在 PubMed、Google Scholar、ScienceDirect、直接开放获取期刊和埃塞俄比亚大学的机构知识库中搜索了相关研究。使用 Stata 17 分析数据。使用纽卡斯尔-渥太华质量评估工具来评估研究的质量。I 平方统计量和 Egger 回归检验分别用于评估异质性和发表偏倚。选择随机效应模型来估计剖宫产后阴道分娩的成功率及其相关因素。本综述的 PROSPERO 注册号为 CRD42023413715。共纳入 10 项研究。研究发现，剖宫产后阴道分娩的成功率为 48.42%。年龄小于 30 岁（合并优势比（OR）3.75，95%置信区间（CI）1.92，7.33），既往阴道分娩史（OR 3.65，95%CI 2.64，504），入院时胎膜破裂（OR 2.87，95%CI 1.94，4.26），入院时宫颈扩张 4cm 或以上（OR 4，95%CI 2.33，6.8），入院时低位（OR 5.07，95%CI 2.08，12.34），无死胎史（OR 4.93，95%CI 1.82，13.36）与剖宫产后阴道分娩成功显著相关。总之，埃塞俄比亚剖宫产后阴道分娩的成功率较低。因此，卫生部应考虑到这些确定的因素，并修订剖宫产试产的管理指南和资格标准。
