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在分娩的第二阶段进行围技术,以减少围创伤和产后并发症

Kerry Dwan¹, Tilly Fox¹, Vittoria Lutje¹

¹Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.

The Cochrane database of systematic reviews

|October 28, 2024

概括

关于预防产后出血和围创伤的围技术的证据非常不确定. 需要更多的研究来了解这些干预措施在分娩中的有效性和可接受性.

科学领域:

产科和妇科产科和妇科
孕产妇健康孕产妇健康
基于证据的医学基于证据的医学.

背景情况:

产后出血 (PPH) 是全球主要的孕产妇死亡原因.
在阴道分娩期间,围流很常见,并导致PPH.
为了防止创伤,存在各种围技术,但缺乏可比证据.

研究的目的:

评估在分娩的第二阶段围技术对围创伤的影响.
评估这些技术对预防产后并发症,包括PPH的影响.

主要方法:

随机对照试验 (RCT) 的系统审查和元分析.
搜索了多个数据库和试验登记册,直到2024年4月.
包括17个RCT与13,695名参与者,评估结果,如周围撕裂和PPH.

主要成果:

大多数围技巧的证据 (例如,放开手,发声,温暖压缩,按摩) 显示对减少围创伤和PPH的影响非常不确定.
温暖的压缩剂可能会减少三度和四度撕裂和围骨疼痛,但证据的确定性低至中等.
热压缩和按摩的组合可能会减少二度眼和PPH,有适度确定性的证据表明增加了母亲的满意度.

结论:

在预防围创伤和PPH方面,围技术的总体证据非常不确定.
需要进一步的研究来澄清这些干预措施的有效性和可接受性.
未来的试验应包括明确的干预描述和过程评估.

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