哪种引产方法更好:同时使用催产素和宫内球囊还是连续使用催产素--系统综述和荟萃分析。

IF 1.7 4区 医学 Q3 OBSTETRICS & GYNECOLOGY
Qian Chen, Huihao Zhou, Yiqin Hu, Jingui Xue
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引用次数: 0

摘要

目的比较催产素和宫腔内球囊在引产中同时使用和连续使用的疗效:方法:对 Cochrane Library、Web of Science、PubMed、ClinicalTrials.gov 和 Embase 等数据库中从开始到 2023 年 11 月的内容进行了全面检索。纳入了研究同时或先后使用催产素和宫内气囊进行妊娠引产的随机对照试验(RCT)。荟萃分析使用 RevMan 5.3 统计软件进行。所选研究之间的异质性采用I2统计量进行评估。二分结果用相对风险(RR)和相应的95%置信区间(CI)估算,连续结果用平均差(MD)衡量:共有 8 项研究被纳入系统综述,涉及 1 315 名患有宫颈不利的单胎和多胎妇女。此外,还进行了分组分析,分别评估了单胎和多胎妇女的情况。与顺序组相比,同时使用催产素和宫内气囊可显著提高无子宫产妇 24 小时内的分娩率(RR = 1.30,95%CI:1.04,1.63, p = 0.02)和多产妇 24 小时内的阴道分娩率(RR = 1.32,95%CI:1.15,1.51, p):这些研究结果支持在无痛引产过程中同时使用宫内气囊和催产素。此外,这种方法也可能对多产妇有益。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Which approach is better for labor induction: simultaneous or sequential administration of oxytocin and intrauterine balloon-a systematic review and a meta-analysis.

Objective: To compare the efficacy of simultaneous and sequential administration of oxytocin and intrauterine balloons in labor induction.

Methods: The databases of Cochrane Library, Web of Science, PubMed, ClinicalTrials.gov, and Embase were thoroughly searched from their inception to November 2023. Randomized controlled trials (RCTs) investigating the simultaneous and sequential use of oxytocin and intrauterine balloons for labor induction in pregnancy were included. The meta-analysis was performed using RevMan 5.3 statistical software. Heterogeneity among the selected studies was evaluated using the I2 statistic. Dichotomous outcomes were estimated using relative risk (RR) with corresponding 95% confidence intervals (CI), while continuous outcomes were measured as the mean difference (MD).

Results: A total of eight studies, involving a total of 1,315 nulliparous and multiparous women with an unfavorable cervix, were included in the systematic review. Moreover, a subgroup analysis was conducted, separately evaluating nulliparous and multiparous women. Compared with the sequential groups, simultaneous use of oxytocin and intrauterine balloons resulted in a significantly higher rate of delivery within 24h in nulliparas (RR = 1.30, 95%CI:1.04, 1.63, p = 0.02), a higher rate of vaginal delivery within 24h in multiparas (RR = 1.32, 95%CI:1.15,1.51, p < 0.00001), a superior rate of delivery within 12h and a shorter time to delivery in both nulliparas and multiparas. No statistically significant differences were observed in cesarean delivery and maternal and neonatal adverse outcomes between the sequential and simultaneous groups.

Conclusions: These findings provide support for the simultaneous use of intrauterine balloons and oxytocin during labor induction in nulliparous women. Additionally, this approach may also prove beneficial for multiparas.

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来源期刊
CiteScore
4.40
自引率
0.00%
发文量
217
审稿时长
2-3 weeks
期刊介绍: The official journal of The European Association of Perinatal Medicine, The Federation of Asia and Oceania Perinatal Societies and The International Society of Perinatal Obstetricians. The journal publishes a wide range of peer-reviewed research on the obstetric, medical, genetic, mental health and surgical complications of pregnancy and their effects on the mother, fetus and neonate. Research on audit, evaluation and clinical care in maternal-fetal and perinatal medicine is also featured.
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