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产后阴道产的国家指南中的禁忌:比较,共识和争议

Merle R van Dijk¹, Christiaan Papatsonis¹, Wessel Ganzevoort^2,3

¹Department of Obstetrics and Gynecology, Onze Lieve Vrouwe Gasthuis (OLVG), Amsterdam, The Netherlands.

Acta obstetricia et gynecologica Scandinavica

|August 18, 2024

概括

阴道后分娩指南缺乏关于禁忌的共识,大多数支持的证据有限. 本次审查建议对更安全的计划性阴道后分娩进行修订的禁忌清单.

科学领域:

产科和妇科产科和妇科
孕产妇和胎儿医学孕产妇和胎儿医学
新生儿结局的结果.

背景情况:

对于阴道部呈现的最佳分娩方式仍在争论中,平衡母亲和新生儿的风险.
计划性阴道分娩可以避免剖腹产,而选择性剖腹产可以减少新生儿不良后果.
由于有限的科学证据和关于阴道部分娩的禁忌的共识,患者选择至关重要.

研究的目的:

系统地审查阴道部分娩的禁忌.
分析现有的科学文献和关于部呈现交付的国家指南.
提供基于证据的建议,针对计划性阴道产的禁忌.

主要方法:

在PubMed,Cochrane,EMBASE,NICE,UpToDate和ClinicalKey的系统文献综述中.
用关键词"部呈现"和"阴道分娩"搜索指南和证据.
包括从1947年到2024年的文献,重点关注术语阴道部分娩的禁忌.

主要成果:

八个指导方针确定了11个禁忌,只有足部部显示共识.
在文献中搜索了43篇文章,讨论了14种潜在的禁忌.
在11个指导方针禁忌中的7个发现了支持性证据,只有两个有实质性证据.

结论:

在国家指导方针中,对于产后阴道产的禁忌存在显著的缺乏共识.
显而易见的是,没有实质性的科学证据支持许多指导方针的禁忌.
为了改善患者选择,建议减少阴道产的禁忌清单.

关键词:

适应性适应性适应性适应性胎儿部位置胎儿部位置这些指导方针是指导方针.系统性审查系统性审查阴道部分娩的时间

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