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首页> 外文期刊>Journal of advanced nursing >Non-clinical interventions that increase the uptake and success of vaginal birth after caesarean section: a systematic review.
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Non-clinical interventions that increase the uptake and success of vaginal birth after caesarean section: a systematic review.

机译：剖宫产术后非临床干预措施可增加阴道分娩的摄取和成功率：系统评价。

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AIM: The aim of this study was to review non-clinical interventions that increase the uptake and/or the success rates of vaginal birth after caesarean section. BACKGROUND: Increases in rates of caesarean section are largely due to repeat caesarean section in a subsequent pregnancy. Concerns about vaginal birth after caesarean section have centred on the risk of uterine rupture. Nonetheless, efforts to increase the vaginal birth rate in these women have been made. This study reviews these in relation to non-clinical interventions. DATA SOURCES: Literature was searched up until December 2008 from five databases and a number of relevant professional websites. REVIEW METHODS: A systematic review of quantitative studies that evaluated a non-clinical intervention for increasing the uptake and/or the success of vaginal birth after caesarean section was undertaken. Only study designs that involved a comparison group were included. Further exclusions were imposed for quality using the Critical Skills Appraisal Programme. RESULTS: National guidelines influence vaginal birth after caesarean section rates, but a greater effect is seen when institutions develop local guidelines, adopt a conservative approach to caesarean section, use opinion leaders, give individualized information to women, and give feedback to obstetricians about mode of birth rates. Individual clinician characteristics may impact on the number of women choosing and succeeding in vaginal birth after caesarean section. There is inconsistent evidence that having private health insurance may be a barrier to the uptake and success of vaginal birth after caesarean section. CONCLUSION: Non-clinical factors can have a significant impact on vaginal birth after caesarean section uptake and success.
机译：目的：本研究的目的是回顾非临床干预措施，以增加剖腹产后阴道分娩的摄取和/或成功率。背景：剖宫产率的提高很大程度上是由于在随后的妊娠中重复剖腹产。剖宫产后阴道分娩的担忧集中在子宫破裂的风险上。尽管如此，已经做出努力以增加这些妇女的阴道出生率。这项研究回顾了与非临床干预有关的这些。数据来源：直到2008年12月，才从五个数据库和许多相关专业网站中检索文献。回顾方法：对定量研究进行了系统的回顾，评估了一种非临床干预措施，以增加剖宫产后阴道摄取量和/或阴道分娩的成功率。仅包括涉及比较组的研究设计。使用关键技能评估计划对质量进行了进一步的排除。结果：国家指南影响剖腹产率后的阴道分娩，但当机构制定本地指南，对剖宫产采取保守方法，使用意见领袖，向妇女提供个性化信息以及向产科医生反馈有关阴道分娩方式时，效果会更大。出生率。个别临床医生的特征可能会影响剖腹产后选择和成功阴道分娩的妇女人数。不一致的证据表明，拥有私人健康保险可能会成为剖腹产后成功接受阴道分娩的障碍。结论：非临床因素可对剖宫产成功和成功后的阴道分娩产生重大影响。

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