بررسی شیوع و متآنالیز اپی‌زیاتومی در خاورمیانه

نوع مقاله : مروری

نویسندگان

1 دانشجوی دکتری بهداشت باروری، کمیته پژوهشی دانشجویان، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

2 دانشیار گروه مامایی و بهداشت باروری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

3 استادیار گروه مامایی و بهداشت باروری، مرکز تحقیقات مامایی و بهداشت باروری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

4 دکتری آمار، مرکز تحقیقات ارولوژی و نفرولوژی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

5 استادیار گروه پرستاری، دانشکده پیراپزشکی و پرستاری آمل، دانشگاه علوم پزشکی مازندران، آمل، ایران.

چکیده

مقدمه: استفاده روتین از اپی‌زیاتومی برای زنانی که به‌روش طبیعی زایمان می‌کنند، توصیه نمی‌شود. با این‌حال مطالعات متعدد در خاورمیانه شیوع آن را بالا گزارش کرده‌اند، ولی برآورد کلی از آن وجود ندارد. مطالعه حاضر با هدف بررسی مروری شیوع و متانالیز اپی‌زیاتومی در خاورمیانه بر اساس مطالعات انجام گرفته در این زمینه انجام شد.
روش‌کار: جهت جستجوی مقالات، پایگاه‌های اطلاعاتیSID ، Magiran،Medline ،Science Direct ،Scopus ،Web of Science ، Embase، ProQuest و موتور جستجوی google scholer با استفاده از کلید واژه‌های شیوع، اپیدمیولوژی، فراوانی، بروز، میزان و اپی‌زیاتومی به دو زبان فارسی و انگلیسی و تمام ترکیبات ممکن با عملگرهای AND و OR مورد جستجو قرار گرفت. محاسبه ناهمگنی مطالعات با استفاده از شاخص I2 ارزیابی شد و جهت بررسی سوگیری از آزمون بگ استفاده شد.
یافته‌ها: 12 مقاله با حجم نمونه 69171 مورد بررسی قرار گرفتند. شیوع کلی اپی‌زیاتومی 67% (95% 78-55 :CI) بود. با استفاده از مدل اثر تصادفی، خطر انجام اپی‌زیاتومی در زنان پرایمی‌پار 2 برابر زنان مولتی‌پار بود که از نظر آماری معنی‌دار بود (01/2=RR، 95%، 63/4-87/0 :CI، 001/0>p، 99/99=I2). همچنین استفاده از اکسی‌توسین با شیوع 80% (95-60%) اپی‌زیاتومی همراه بود.
نتیجه‌گیری: با توجه به میزان بالای اپی‌زیاتومی در خاورمیانه علی‌رغم استاندارد تعیین شده توسط سازمان جهانی بهداشت، نیاز مبرم به برنامه‌ریزی در جهت کاهش این میزان می‌باشد. بنابراین توصیه می‌شود از روش‌های مؤثر در کاهش نیاز به اپی‌زیاتومی در زنان پرایمی‌پار استفاده شود و از انجام مداخلات غیرضروری بالینی نظیر استفاده از اکسی‌توسین اجتناب گردد.

کلیدواژه‌ها

عنوان مقاله [English]

Prevalence and meta-analysis of episiotomy in the Middle East

نویسندگان [English]

  • Malihe Ghiasvand 1
  • Fatemeh Nahidi 2
  • Sedigheh Sedigh Mobarakabadi 3
  • Nasrin Broumandnia 4
  • Hamid Sharifnia 5
1 PHD student of Reproductive Health, Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
2 Associate Professor, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
3 Assistant Professor, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
4 PhD in Statistics, Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
5 Assistant Professor, Department of Nursing, Amol School of Paramedical Sciences and Nursing, Mazandaran University of Medical Sciences, Amol, Iran.
چکیده [English]

Introduction: Routine use of episiotomy is not recommended for women giving birth naturally. However, several studies in the Middle East have reported that it has high prevalence, but there is no general estimate. This study was performed with aim to review the prevalence and met-analysis of episiotomy in the Middle East based on studies conducted in this field.
Methods: To search for articles, the databases of SID, Magiran, Medline, Science Direct, Scopus, Web of Science, Embase, ProQuest and google scholer search engines using the keywords of prevalence, epidemiology, frequency, incidence, rate and episiotomy in both languages of Persian and English and all possible combinations were searched with AND and OR operators. Calculation of heterogeneity of the studies was evaluated using I2 index and Bag test was used to examine the bias.
Results: Twelve articles with a sample size of 69171 were reviewed. The overall prevalence of episiotomy was 67% (95% CI: 55-78). Using the random effect model, the risk of episiotomy in primiparous women was two times than multiparous women, which was statistically significant (RR = 2.01, 95% CI: 0.87-4.63, p <0.001; I2 = 99.99). Oxytocin use was also associated with an 80% (60-95%) prevalence of episiotomy.
Conclusion: Due to the high rate of episiotomy in the Middle East, despite the standard set by the World Health Organization, there is an urgent need for planning to reduce this rate. Therefore, it is recommended to use effective methods to reduce the need for episiotomy in primiparous women and to avoid unnecessary clinical interventions such as using oxytocin.

کلیدواژه‌ها [English]

  • Frequency
  • Episiotomy
  • Middle East
  • Prevalence
  • Review

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مجله زنان، مامایی و نازایی ایران
دوره 24، شماره 4
تیر 1400
صفحه 90-99

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