催产素和阴道迪诺普洛斯在分娩诱导:一个系统的审查和元分析
Ting-An Chang1, Yi-Rong Li1, Dah-Ching Ding1,2
1Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien, Taiwan, Republic of China.
概括
前列腺素E2 (PGE2) 和催产素显示出类似的安全性和有效性来诱导分娩 (IOL). 这次元分析发现这两种药物之间阴道分娩,剖腹产率或分娩时间没有显著差异.
科学领域:
- 产科和妇科 产科和妇科
- 生殖医学 生殖医学
- 临床药理学 临床药理学
背景情况:
- 前列腺素E2 (PGE2) 与催产素用于引发分娩的比较疗效和安全性仍然是正在进行的辩论的主题.
- 引产 (IOL) 是一种常见的产科手术,可使用各种药物药物.
研究的目的:
- 系统地评估和比较前列腺素E2 (PGE2) 和催产素用于诱导分娩 (IOL) 的安全性和有效性.
- 提供随机临床试验 (RCT) 的元分析,比较这些两种药物在特定的产科人群中.
主要方法:
- 在PubMed,Embase,Web of Science,Cochrane图书馆和ClinicalTrials.gov进行了全面的文献搜索,截至2023年4月23日.
- 包括随机临床试验,比较催产素与阴道迪诺普洛斯 (PGE2) 在单独怀孕的妊娠年龄 (GA) ≥34周与完整的膜.
- 分析使用了一种随机效应模型,用于二分结果的相对风险 (RR) 和连续结果的标准化平均差异. 通过使用柯克兰偏差风险工具 (RoB 2) 评估研究质量.
主要成果:
- 九个涉及1071名患者的RCT (534名PGE2组,537名催产素组) 被纳入了元分析.
- 在PGE2和催产素之间没有观察到阴道分娩率 (RR: 1.05;95% CI: 0.95-1.16),剖腹产率 (RR: 0.84;95% CI: 0.52-1.35) 或诱导-分娩间隔 (SMD: 0.09;95% CI: -0.67至0.85) 的统计学意义上的差异.
- 对胎儿痛苦和子宫过度刺激的结果在所有研究中都是一致的,排除了进一步的元分析.
结论:
- 现有的文献表明,催产素和前列腺素E2 (PGE2) 在妊娠年龄≥36周的妇女中用于分娩诱导时,对分娩结果和安全性具有可比的影响.
- 研究人员发现,低剂量和高剂量的催产素可用于诱导分娩,即使有不利的宫状况.
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