A systematic review of clinical practice guidelines on uncomplicated birth.

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Clinical Guidelines
Authored By
Zhao Y, Lu H, Zang Y, Li X
Authored On
Interests
Obstetrics & Gynecology
Speciality
Obstetrics & Gynecology
Book Detail
volume
127
ISSN
1471-0528
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ISSN
1471-0528
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true
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Additional Info
["Zhao Y, Lu H, Zang Y, Li X","Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 100935741 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1471-0528 (Electronic) Linking ISSN: 14700328 NLM ISO Abbreviation: BJOG Subsets: MEDLINE","Journal Article; Systematic Review","2020-06-01","BJOG : an international journal of obstetrics and gynaecology [BJOG] 2020 Jun; Vol. 127 (7), pp. 789-797. Date of Electronic Publication: 2020 Jan 14.","English","1471-0528","Practice Guidelines as Topic*, Delivery, Obstetric\/*standards , Obstetrics\/*standards, Adult ; Female ; Humans ; Infant, Newborn ; Parturition ; Pregnancy","Adult, Female, Humans, Infant, Newborn, Parturition, Pregnancy, Practice Guidelines as Topic, Delivery, Obstetric standards, Obstetrics standards","BJOG : an international journal of obstetrics and gynaecology","127"]
Description
Background: Clinical practice guidelines on uncomplicated birth provide clinical practice guidance and help to reduce unnecessary, non-evidence-based and potentially harmful intrapartum care practices. Little is known about the trustworthiness and consistency of these guidelines.<br />Objectives: To appraise guidelines relevant to uncomplicated birth, and summarise consensus and non-consensus recommendations.<br />Search Strategy: Eight literature databases and the websites of guideline development institutions and organisations of obstetricians, gynaecologists and midwives were searched from January 2008 to October 2018.<br />Selection Criteria: Guidelines that: reported in Chinese or English; labelled guideline, or recommendation, or consensus, or practice parameter, or position paper/stand; with uncomplicated birth being the primary objectives or comprised chapter(s); and were the most recently published or updated versions.<br />Data Collection and Analysis: Two reviewers independently assessed guideline quality using the AGREE II instrument, and synthesised consensus and non-consensus recommendations using the content analysis approach.<br />Main Results: Eleven guidelines met the inclusion criteria. The WHO and NICE guidelines were deemed to have the highest methodological quality. Twenty-three discrepant recommendations and 39 groups of unanimous recommendations (containing 113 individual ones) were identified, among which 14 recommendations including eating and drinking as desired, prophylactic uterotonics, routine amniotomy and episiotomy were included in five or more guidelines. Perineal massage, uterine massage, active or expectant management at the third stage and use of hands-on or hands-poised technique were identified as the main discrepant recommendations.<br />Conclusions: Two guidelines with higher methodological quality and key clinical guideline recommendations, including both consensus and non-consensus ones, on uncomplicated birth were identified.<br />Tweetable Abstract: Clinical guidelines of uncomplicated birth agree and disagree on several key recommendations.<br /> (© 2019 Royal College of Obstetricians and Gynaecologists.)
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