Infant’s safety in cesarean section surgery: a meta-synthesis

Abstract

Background: Patient safety is the most important clinical priority, especially in high-risk groups such as infants. Neonatal safety after a C-section is more challenging because despite all efforts and guidelines, patient safety is still a major challenge in the operating room. This meta-synthesis study aimed to investigate the factors affecting neonatal safety during a C-section and to provide improved strategies. Methods: This systematic review was carried out through meta-synthesis. A total of 112 articles were found and finally, 37 articles were selected for research after review. The articles were first reviewed by title and abstract and those which met the inclusion criteria were entered into the study. The inclusion criteria were papers in English and Persian, relevance to neonatal safety and being published before 2019. Exclusion criteria were papers that were not relevant to safety or neonate. In the next step, the quality of the articles was reviewed simultaneously by two separate researchers using the Strengthening the Reporting of Observational studies in Epidemiology" STROBE" and consolidated standards of reporting trials "CONSORT" Review Guidelines. Data were analyzed using content analysis. Results: The most important risk factors of neonatal safety during a C-section included anemia due to early cord clamping, jaundice due to delayed cord clamping, nosocomial infection, hypothermia and hyperthermia, inappropriate positioning of the infant, fall, medication error, operative damage and error in registering infants identity. Conclusion: For improvement of neonatal safety during C-section, it is important to consider teamwork, team and interdisciplinary continuous training through simulation, accurate identification of mothers and accurate registration of mothers and infants' identity on the identification band, accurate medication and right dosage, safely carrying and sleeping, observing infection control tips, maintaining operating room temperature and humidity, cord clamping after 30 seconds before birth and 2 minutes after birth.