Abstract
BackgroundObstructed labor accounted for 22% of obstetrical complications and 9% of all maternal deaths in low- and middle-income countries. Even though there are separate studies regarding obstructed labor and its complication in Ethiopia, their results are inconsistent. The objectives of this review will be to estimate the pooled the prevalence of obstructed labor and to identify adverse feto-maternal outcomes associated with obstructed labor in Ethiopia.MethodsPreferred Reporting Items for Systematic Reviews and Meta-Analyses guideline will be followed to conduct this systematic review and meta-analysis. The databases we will search will be PubMed, Cochrane Library, Google Scholar, CINAHL, African Journals Online, Dimensions, and Summon per country online databases. To search the relevant literature, we will use the following key search terms: “prevalence,” “adverse outcome,” “obstructed labour,” “maternal near miss,” “neonatal near miss,” “perinatal outcome,” “cesarean section,” “obstetric fistula,” “uterine rupture,” and “Ethiopia.” Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument will be used for evaluating the quality of the studies. Appropriate statistical tests will be conducted to quantify the between studies heterogeneity and for the assessment of publication bias. We will check individual study influence analysis and also do subgroup analysis. The STATA version 15 will be used for statistical analysis.DiscussionOur systematic review and meta-analysis will provide the pooled prevalence of obstructed labor and its association with adverse feto-maternal outcomes in Ethiopia. The finding of this study will be helpful to design appropriate preventive and promotive strategies for reducing of obstructed labor-related maternal mortality.Systematic review registrationPROSPERO CRD42020196153.
Highlights
Obstructed labor accounted for 22% of obstetrical complications and 9% of all maternal deaths in low- and middle-income countries
Studies conducted so far show that the burden of Obstructed labor (OL) and its adverse fetomaternal outcomes are high and a common challenge in Ethiopia [16,17,18,19,20,21,22,23], with the leading cause of maternal mortality associated with OL being uterine rupture [24]
The protocol describes a planned systematic review and meta-analysis to determine the prevalence of OL and adverse feto-maternal outcome associated with OL in Ethiopia
Summary
Protocol and registration This systematic review and meta-analysis will be conducted following the recommendation of the Preferred Reporting Items for Systematic Reviews and MetaAnalysis (PRISMA-P) guidelines. Eligibility criteria Study design/characteristics Observational studies (cross-sectional, case controls, and cohort) that report the prevalence of OL and the association between obstructed and adverse feto-maternal outcomes among mothers or women who have recently given birth will be considered for inclusion. The Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument will be used to appraise the quality of included studies. This instrument provides different tools for assessing quality according to study design. Data synthesis and statistical analysis Narrative synthesis We will synthetize primary studies to explore heterogeneity descriptively such as structured narratives or summary tables, measures of prevalence of OL, and its associated feto-maternal outcome. The publication bias, which represents the tendency to report positive findings [37], will be visually checked by inspecting the funnel plot and objectively by using the Harbord’s regression test to statistically assess the asymmetry of the funnel plot [38]
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