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护理包的有效性,以减少剖腹产安全:一个系统的审查和元分析
Kate O'Doherty1, Aileen Rothwell2, Valerie Smith3
1Royal College of Surgeons in Ireland, Dublin, Ireland.
PloS one
|June 13, 2025
概括
护理包,一套干预措施,可以减少剖腹产 (CS). 这次审查发现了护理包减少整体和紧急CS的证据,但需要更多的研究.
科学领域:
- 产科和妇科 产科和妇科
- 基于证据的医学基于证据的医学.
- 孕产妇和胎儿医学 孕产妇和胎儿医学
背景情况:
- 全球剖腹产的发生率正在上升.
- 建议提供包括多项干预措施在内的护理包来管理这一趋势.
研究的目的:
- 系统地审查护理包在减少剖腹产率方面的有效性.
- 评估护理套餐对母亲和新生儿结局的影响.
主要方法:
- 从2000年1月到2024年6月,对随机和非随机研究进行系统审查和元分析.
- 搜索内容包括MEDLINE,CINAHL,CENTRAL,Embase,灰色文学和专业网站.
- 数据提取和元分析 (随机效应模型) 侧重于CS率,辅助分娩,新生儿入院和合规性.
主要成果:
- 包括十项非随机研究.
- 护理套餐显著降低了整体CS (OR 0.83,95% CI 0.72~0.97) 和紧急CS (OR 0.82,95% CI 0.68~0.98) 的情况.
- 在辅助性阴道分娩或新生儿重症监护入院方面没有发现显著差异. 合规程度从50%到92%不等.
结论:
- 护理包显示出降低剖腹产率的潜力,特别是紧急CS.
- 这些发现的证据确定性非常低.
- 高质量的随机对照试验是必要的,以确认护理包的安全性和有效性,以减少CS.
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