高剂量与低剂量催产素的劳动诱导协议:一个系统的审查和元分析
Jennifer L Grasch1, Maged M Costantine1, Alison G Cahill2
1Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, Ohio.
American journal of obstetrics & gynecology MFM
|May 7, 2025
概括
与低剂量协议相比,高剂量的催产素用于产业诱导并没有增加剖腹产率. 然而,高剂量的催产素与较少的产后出血有关,尽管研究质量有限.
科学领域:
- 产科和妇科 产科和妇科
- 生殖医学 生殖医学
- 围产期护理 围产期护理
背景情况:
- 引产是一种常见的产科手术.
- 催产素是用于劳动诱导的主要药物.
- 最佳的催产素剂量方案仍然是调查的主题.
研究的目的:
- 系统地审查和综合有关母亲和新生儿结局的证据,比较高剂量与低剂量的催产素用于分娩诱导.
- 评估不同催产素剂量策略对剖腹产分娩率和其他关键产科结果的影响.
主要方法:
- 随机和观察性研究的系统审查.
- 搜索了多个数据库 (PubMed,Embase,Scopus,CINAHL,Cochrane) 和临床试验网站.
- 包括比较特定低剂量和高剂量催产素的劳动诱导协议的研究.
- 使用PRISMA指南和Cochrane工具提取数据并评估偏差风险.
- 使用随机效应模型计算了初级 (剖腹产) 和二次结果的相对风险.
主要成果:
- 包括6项研究 (7850项交付),所有研究均具有中等或高偏差风险.
- 在高剂量和低剂量催产素方案之间的剖腹产率没有显著差异 (26.0%对28.4%).
- 高剂量的催产素与分娩后出血的频率明显降低 (7.6%与9.9%相比).
- 没有观察到自发性阴道分娩,手术性阴道分娩,分娩持续时间,子宫太基斯托力或新生儿发病率的差异.
结论:
- 目前的证据表明,高剂量和低剂量催产素用于分娩诱导之间的剖腹产分娩率没有差异.
- 高剂量的催产素可以降低产后出血的风险.
- 存在显著的方法限制和需要高质量的试验,以建立最佳的催产素剂量来诱导分娩.
相关概念视频
01:45Endocrine Signaling
63.8K
Endocrine cells produce hormones to communicate with remote target cells found in other organs. The hormone reaches these distant areas using the circulatory system. This exposes the whole organism to the hormone but only those cells expressing hormone receptors or target cells are affected. Thus, endocrine signaling induces slow responses from its target cells but these effects also last longer.
63.8K
01:29Local Anesthetics: Clinical Application as Epidural Anesthesia
399
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
399