关于正常分娩和分娩的临床实践指南:系统审查
María Loreto Hernández-Martínez1, Alonso Molina-Rodríguez2,3, Marta Maes-Carballo4,5
1Registred Midwife in Hospital Universitario Clínico San Cecilio in Granada, Granada, Spain.
对于正常分娩的临床实践指南 (CPG) 往往缺乏质量和过时. 需要改进,以确保对母亲和新生儿健康的可靠,一致的建议.
科学领域:
- 孕产妇和新生儿健康
- 基于证据的实践.
- 医疗保健指导方针开发
背景情况:
- 临床实践指南 (CPG) 对基于证据的孕产妇和新生儿护理至关重要.
- 在CPG中的不一致性可能会导致医疗保健提供者之间的混乱.
- 确保CPG的质量和一致性对于最佳的患者结果至关重要.
研究的目的:
- 系统地分析国际CPG的质量和报告标准,重点关注正常分娩.
- 总结这些CPG中提供的关键建议.
- 确定在CPG开发和传播方面需要改进的领域.
主要方法:
- 在主要数据库 (MEDLINE,Cochrane,Scopus,Web of Science) 和通过直接推广进行了系统的文献搜索.
- 在2010年至2024年12月期间发布的CPG被包括在内,不论语言.
- 评估研究和评估指南II (AGREE II) 和报告项目实践指南在医疗保健 (RIGHT) 工具被用于评估质量和报告.
主要成果:
- 对25个CPG的分析显示,AGREE II质量评分的中位数为54%,RIGHT报告的中位数为50%.
- 很大一部分 (56%) 的CPG表现出报告质量不佳,只有8%的人认为他们得到了充分的信息.
- 整个CPG的关键建议包括支持人员,避免例行干预,流体摄入,分娩期间的移动性和皮肤与皮肤接触.
结论:
- 目前大多数用于正常分娩的CPG已经过时,在质量和报告方面存在缺陷.
- 迫切需要加强CPG的开发过程.
- 改善是必要的,以提供有效,一致和最新的建议,以改善孕产妇和新生儿健康结果.
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