素酸用于预防阴道分娩后产后出血
Christa Rohwer1, Anke C Rohwer2, Catherine Cluver1
1Department of Obstetrics and Gynaecology, Faculty of Health Sciences, Stellenbosch University and Tygerberg Hospital, Tygerberg, South Africa.
The Cochrane database of systematic reviews
|January 15, 2025
概括
预防性三胺酸 (TXA) 在预防阴道分娩后产后出血 (PPH) 方面几乎没有差异. 证据不足以得出结论TXA对严重的孕产妇结果的影响.
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) 是孕产妇死亡的一个重要原因.
- 胺酸 (TXA) 是一种抗纤维素解药物,具有预防PPH的潜力.
- 在阴道分娩后预防性TXA使用的证据需要更新评估.
研究的目的:
- 评估特兰胺酸 (TXA) 预防阴道分娩后妇女的PPH的疗效和安全性.
- 为了比较TXA与安慰剂或没有治疗,有或没有子宫激素.
- 更新关于这个主题的先前系统审查.
主要方法:
- 随机对照试验 (RCT) 的系统审查和元分析.
- 包括符合可信度标准的潜在注册试验.
- 评估关键结局,包括血液损失 (≥500毫升,≥1000毫升) 和重要的结局,如孕产妇死亡率和发病率.
主要成果:
- 预防性TXA在血液损失≥500毫升 (高确定性证据) 中几乎没有差异.
- TXA可能导致血液损失≥1000毫升和严重发病率的差异很小或不存在 (中度确定性证据).
- 有关TXA对孕产妇死亡,血栓栓塞事件和子宫切除术的影响的证据非常不确定.
结论:
- 添加到标准护理中的预防性TXA在预防阴道分娩后的PPH方面几乎没有益处.
- 目前的证据不支持对所有经历阴道分娩的妇女进行常规预防性TXA.
- 需要进一步的研究来澄清与TXA相关的风险,特别是关于罕见但严重的不良事件.
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