预防产后出血:关于子宫激素的使用途径的网络元分析
Argyro Papadopoulou1, Georgios Tournas2, Georgios Georgiopoulos2
1Institute of Metabolism and Systems Research, University of Birmingham, Heritage Building, Mindelsohn Way, Birmingham B15 2TH United Kingdom; Department of Obstetrics and Gynaecology, National and Kapodistrian University of Athens, 80 Vasilissis Sofias Avenue, Athens 11528, Greece.
静脉注射的催产素和碳素可能是预防产后出血的最有效的预防性子宫激素,具有有利的副作用概况. 建议对服用途径和患者偏好进行进一步研究.
科学领域:
- 产科和妇科 产科和妇科
- 药理学 药理学是指药理学的学科.
- 基于证据的医学基于证据的医学.
背景情况:
- 产后出血 (PPH) 仍然是全球孕产妇死亡的主要原因.
- 预防性子宫激素对预防PPH至关重要,但最佳药物和施用途径需要澄清.
研究的目的:
- 进行网络元分析,比较预防性子宫激素在PPH预防中的有效性和安全性.
- 确定最佳的施用途径,以最大限度地提高子宫发育效果,同时最大限度地减少副作用.
主要方法:
- 系统地搜索多个数据库和临床试验注册表的文献,直到2022年9月.
- 包括在劳动的第三阶段的妇女随机对照试验.
- 网络元分析使用风险比率和平均差异,并对证据确定性进行GRADE评估.
主要成果:
- 分析了181项涉及122,867名女性的研究.
- 在预防PPH方面,静脉注射的催产素和碳素可能比肌内催产素更优越.
- 肌肉内注射的厄戈米特林加上催产素组合也显示出可能的有效性.
- 静脉输入的催产素和卡贝托表现出有利的副作用概况.
结论:
- 静脉注射的卡贝托和催产素,以及肌肉内施用的厄戈美特林-催产素组合,可能是预防PPH的最有效的子宫激素.
- 证据质量一般中度,全球不一致性较低.
- 需要进一步大规模研究药物给药途径和患者的观点.
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