{"title":"Immediate delivery versus expectant management in women with chronic hypertension: a meta-analysis of randomized controlled trials.","authors":"Giovanni Sisti, Gal Rubin, Antonio Schiattarella","doi":"10.23736/S2724-606X.23.05194-1","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>The current guidelines regarding chronic hypertension during pregnancy recommend induction of labor at term. The only previous meta-analysis on this topic found two randomized controlled trials but failed to pool together their results. We aimed to find the best literature-based evidence regarding delivery timing in chronic hypertension during pregnancy.</p><p><strong>Evidence acquisition: </strong>We searched the following electronic databases: MEDLINE, EMBASE, Scopus, ClinicalTrials.gov, the PROSPERO International Prospective Register of Systematic Reviews, and the Cochrane Central Register of Controlled Trials, Google Scholar. We selected randomized controlled trials comparing expectant management versus immediate delivery. The search was performed by two authors and the conflicts resolved in meetings. Data collection and analysis: we collected maternal and neonatal outcomes in a metanalysis following the random-effects model.</p><p><strong>Evidence synthesis: </strong>Two studies were found. The summary effect measure was 1.1 (C.I. 0.51-2.1) regarding the maternal outcomes, 2.6 (C.I. 0.91-7.44) regarding the neonatal outcomes, and 1.5 (C.I. 0.8-2.79) combined. There was no statistically significant difference between maternal and neonatal outcomes (P=0.2).</p><p><strong>Conclusions: </strong>The results of our meta-analysis pointed towards a non-difference between immediate delivery and expectant management, in women with chronic hypertension.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":null,"pages":null},"PeriodicalIF":1.6000,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Minerva obstetrics and gynecology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.23736/S2724-606X.23.05194-1","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/5/4 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: The current guidelines regarding chronic hypertension during pregnancy recommend induction of labor at term. The only previous meta-analysis on this topic found two randomized controlled trials but failed to pool together their results. We aimed to find the best literature-based evidence regarding delivery timing in chronic hypertension during pregnancy.
Evidence acquisition: We searched the following electronic databases: MEDLINE, EMBASE, Scopus, ClinicalTrials.gov, the PROSPERO International Prospective Register of Systematic Reviews, and the Cochrane Central Register of Controlled Trials, Google Scholar. We selected randomized controlled trials comparing expectant management versus immediate delivery. The search was performed by two authors and the conflicts resolved in meetings. Data collection and analysis: we collected maternal and neonatal outcomes in a metanalysis following the random-effects model.
Evidence synthesis: Two studies were found. The summary effect measure was 1.1 (C.I. 0.51-2.1) regarding the maternal outcomes, 2.6 (C.I. 0.91-7.44) regarding the neonatal outcomes, and 1.5 (C.I. 0.8-2.79) combined. There was no statistically significant difference between maternal and neonatal outcomes (P=0.2).
Conclusions: The results of our meta-analysis pointed towards a non-difference between immediate delivery and expectant management, in women with chronic hypertension.
简介关于妊娠期慢性高血压的现行指南建议在临产时进行引产。之前关于该主题的唯一一项荟萃分析发现了两项随机对照试验,但未能将其结果汇总在一起。我们的目标是找到有关妊娠期慢性高血压分娩时机的最佳文献证据:我们检索了以下电子数据库:我们检索了以下电子数据库:MEDLINE、EMBASE、Scopus、ClinicalTrials.gov、PROSPERO International Prospective Register of Systematic Reviews、Cochrane Central Register of Controlled Trials、Google Scholar。我们选择了比较预产期管理与立即分娩的随机对照试验。检索工作由两位作者共同完成,并在会议上解决了冲突问题。数据收集与分析:我们收集了产妇和新生儿的结果,并按照随机效应模型进行了荟萃分析:发现两项研究。孕产妇结局的简要效应测量值为 1.1(C.I. 0.51-2.1),新生儿结局的简要效应测量值为 2.6(C.I. 0.91-7.44),综合效应测量值为 1.5(C.I. 0.8-2.79)。孕产妇和新生儿结局之间没有统计学意义上的差异(P=0.2):我们的荟萃分析结果表明,对于患有慢性高血压的妇女来说,立即分娩和预产期管理之间没有差异。