关于圆圈布置的指导方针:一个比较的系统审查
Aya Mudrik1, Romi Levy2, Alessandro Petrecca3
1Ben-Gurion University of the Negev, Be'er Sheva, Israel (Mudrik).
American journal of obstetrics & gynecology MFM
|June 20, 2025
概括
对于宫和腹部围的专业协会指南显示,在关键指示方面存在共识,但在其他方面存在重大分歧,影响了临床实践. 为了实现一致的患者护理,需要进一步协调.
科学领域:
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 产科 产科 产科 产科 产科
- 妇科外科手术 妇科外科
背景情况:
- 对于宫和腹部带的专业社会指导方针的变化导致临床实践和患者结果不一致.
- 缺乏指导方针一致性可能会影响 cerclage 程序的标准化.
研究的目的:
- 系统地识别,总结和比较专业医学协会关于宫和腹部 cerclage 的指导方针.
- 突出各个领域的共识和分歧,围绕建议.
主要方法:
- 专业社会准则的系统审查和叙事综合.
- 使用AGREE II仪器进行质量评估.
- 对指示,禁忌,时间,技术和术后管理的建议进行比较分析.
主要成果:
- 包括来自10个专业协会的20条指导方针,共识在于历史指示的 cerclage (≥3次损失),超声指示的 cerclage (<10毫米子宫),以及之前失败或子宫不足的腹部 cerclage.
- 关于一个损失 (ACOG和其他人) 后的 cerclage 指示,身体检查 cerclage (24 vs. 28 周) 的时间,以及发生的膜的管理存在分歧.
结论:
- 虽然对 cerclage 的关键指示普遍达成一致,但在指南中仍然存在显著的差异.
- 发现的差异强调了需要在专业社会建议中更加一致,以改善临床实践和患者在 cerclage 程序的结果.
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