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预防性抗生素用于手动移除阴道分娩中保留的胎盘
Kiattisak Kongwattanakul1, Porjai Pattanittum2, Apiwat Jongjakapun1
1Department of Obstetrics and Gynaecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
The Cochrane database of systematic reviews
|October 30, 2024
概括
预防性抗生素用于手动移除保留的胎盘的有效性是不确定的. 有证据表明,产后出血或新生儿重症监护室入院的差异很小或不存在,对其他结果的数据有限.
科学领域:
- 产科和妇科 产科和妇科
- 预防传染病 预防传染病
- 基于证据的医学基于证据的医学.
背景情况:
- 保留的胎盘可以导致产后出血和感染.
- 手动切除胎盘会增加感染的风险.
- 有时使用预防性抗生素,但证据有限.
研究的目的:
- 评估预防性抗生素在阴道分娩后手动移除保留的胎盘的有效性.
- 为了比较抗生素的有效性和不良影响.
- 为了确定最佳的预防性抗生素治疗方案.
主要方法:
- 随机对照试验和非随机研究的系统审查和元分析.
- 搜索了多个数据库,直到2024年5月.
- 使用ROBINS-I工具评估偏差风险.
主要成果:
- 包括四个回顾性队列研究 (974名参与者).
- 非常低的确定性证据显示,对产后子宫内膜炎没有明确的影响.
- 低确定性证据表明,产后出血或新生儿重症监护室入院的差异很小或不存在.
结论:
- 在保留的胎盘切除中,预防性抗生素的证据是不确定的.
- 需要进一步进行多中心随机对照试验.
- 在关键的母亲或新生儿结局方面没有观察到显著的益处.
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