预防产后出血的子宫激活剂:一个网络的元分析
Ioannis D Gallos1, Idnan Yunas2, Adam J Devall2
1UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
The Cochrane database of systematic reviews
|April 16, 2025
概括
厄尔戈米特林加上催产素和米索普罗斯托尔加上催产素可能比标准催产素更有效地预防产后出血 (PPH). 然而,大多数药物,除卡贝托辛外,与催产素相比,会增加副作用的风险.
科学领域:
- 产科和妇科 产科和妇科
- 孕产妇健康 孕产妇健康
- 药理学 药理学是指药理学的学科.
背景情况:
- 产后出血 (PPH) 是全球主要的孕产妇死亡原因.
- 目前世界卫生组织 (WHO) 的指导方针建议10 IU的催产素用于PPH预防.
- 关于具有最少副作用的最有效子宫激活剂存在不确定性.
研究的目的:
- 确定预防PPH最有效的子宫增生剂.
- 为了比较各种子宫激活剂的有效性和副作用概况.
- 根据有效性和安全性对子宫激活剂进行排名.
主要方法:
- 122项随机对照试验 (RCT) 的网络元分析,涉及121,931名女性.
- 包括将子宫激素与安慰剂或没有治疗进行比较的RCT.
- 评估主要结果 (PPH ≥500毫升和PPH ≥1000毫升) 和次要结果 (例如,输血,吐,发烧).
主要成果:
- 与催产素相比,埃尔戈米特林加催产素和米索普罗斯托尔加催产素在预防PPH≥500毫升方面具有更高的有效性.
- 大多数药物,除了注射性前列腺素外,在预防PPH≥500毫升方面是有效的,而不是安慰剂.
- 除卡贝托辛外,所有药物与与催产素相比的副作用增加有关.
结论:
- 与标准催产素相比,埃尔戈美林加催产素和米索普罗斯托尔加催产素可以提供更好的PPH预防.
- 虽然有效,但大多数子宫激活剂的副作用风险比催产素更高.
- 卡贝托辛似乎具有与催产素相似的有效性和副作用.
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