Enemas during labour.
Cochrane Database Syst Rev
; (5): CD000330, 2013 May 31.
Article
em En
| MEDLINE
| ID: mdl-23728632
ABSTRACT
BACKGROUND:
Although the use of enemas during labour usually reflects the preference of the attending healthcare provider, enemas may cause discomfort for women.OBJECTIVES:
To assess the effects of enemas applied during the first stage of labour on maternal and neonatal outcomes. SEARCHMETHODS:
We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (17 May 2012), the Cochrane Central Register of Controlled Trials and Database of Abstracts of Reviews of Effectiveness (The Cochrane Library 2012, Issue 5), PubMed (1966 to 17 May 2012), LILACS (17 May 2012), the Search Portal of the International Clinical Trials Registry Platform (ICTRP) (17 May 2012), Health Technology Assessment Program, UK (17 May 2012), Medical Research Council, UK (17 May 2012), The Wellcome Trust, UK (17 May 2012) and reference lists of retrieved articles. SELECTION CRITERIA Randomised controlled trials (RCTs) in which an enema was administered during the first stage of labour and which included assessment of possible neonatal or puerperal morbidity or mortality. DATA COLLECTION ANDANALYSIS:
Two review authors independently assessed studies for inclusion. MAINRESULTS:
Four RCTs (1917 women) met the inclusion criteria. One study was judged as having a low risk of bias. In the meta-analysis we conducted of two trials, we found no significant difference in infection rates for puerperal women (two RCTs; 594 women; risk ratio (RR) 0.66, 95% confidence (CI) 0.42 to 1.04). No significant differences were found in neonatal umbilical infection rates (two RCTs; 592 women; RR 3.16, 95% CI 0.50 to 19.82; I² 0%. In addition, meta-analysis of two studies found that there were no significant differences in the degree of perineal tear between groups. Finally, meta-analysis of two trials found no significant differences in the mean duration of labour. AUTHORS'CONCLUSIONS:
The evidence provided by the four included RCTs shows that enemas do not have a significant beneficial effect on infection rates such as perineal wound infection or other neonatal infections and women's satisfaction. These findings speak against the routine use of enemas during labour, therefore, such practice should be discouraged.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Infecção Puerperal
/
Infecções Bacterianas
/
Umbigo
/
Primeira Fase do Trabalho de Parto
/
Enema
Tipo de estudo:
Clinical_trials
/
Etiology_studies
/
Health_technology_assessment
/
Risk_factors_studies
/
Systematic_reviews
Limite:
Female
/
Humans
/
Pregnancy
Idioma:
En
Revista:
Cochrane Database Syst Rev
Assunto da revista:
PESQUISA EM SERVICOS DE SAUDE
Ano de publicação:
2013
Tipo de documento:
Article
País de afiliação:
Estados Unidos