Abstract
Safe and timely access to cesarean section (CS) in low- and middle-income countries (LMIC) remains a significant challenge. To compare maternal and perinatal outcomes of CS by non-physician clinicians (NPCs) versus physicians in LMIC. A systematic search of Ovid MEDLINE, EMBASE, Cochrane Library (including CENTRAL), Web of Science, and LILACS was performed from inception to January 2022. Data were extracted by two independent reviewers and meta-analysis was performed when possible. Ten studies from seven African countries were included. There was no significant difference in maternal mortality for CS performed by NPCs versus physicians (odds ratio [OR] 1.09, 95% confidence interval [CI] 0.56-2.14, P= 0.8, I2 = 70%, P< 0.05, eight studies, n= 20 711) or in perinatal mortality (OR 1.18, 95% CI 0.86-1.61, P= 0.3, I2 = 88%, n= 19 716). Despite heterogeneous clinical settings between providers, there was no difference in the rates of wound infection or re-operation, although there was a higher rate of wound complications (such as dehiscence) in the NPC group (OR 1.89, 95% CI 1.21-2.95, P= 0.005, n= 6507). NPCs have comparable maternal and neonatal outcomes for CS compared with standard providers, albeit with increased odds of wound complication. CRD42020217966.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
More From: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.