产前捆绑和干预措施在减少阴道分娩相关会阴创伤方面的功效：系统性综述。

IF 2.1 4区医学 Q2 OBSTETRICS & GYNECOLOGY

European journal of obstetrics, gynecology, and reproductive biology Pub Date : 2025-02-01 DOI:10.1016/j.ejogrb.2024.12.008

Giovanni Morganelli , Stefania Fieni , Sara dell’Omo , Vito Andrea Capozzi , Maurizio Di Serio , Andrea Dall’Asta , Tullio Ghi

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引用次数: 0

摘要

目的：本系统综述的目的是总结目前关于预防措施和一揽子措施的证据，包括多种技术的组合，旨在减少阴道分娩相关的会阴损伤。方法：作者根据现行PRISMA指南，结合识别的关键词和索引词，在不同的数据库（PubMed、MEDLINE、EMBASE）上独立进行文献系统研究。从2000年开始，这项研究仅限于用英语发表的论文。使用与先前发表的综述和符合纳入标准的元分析相似的论文作为交叉参考，以检查潜在的进一步纳入。结果：共纳入14篇文献，分为2项随机对照试验和12项队列研究（4项前瞻性队列研究、6项回顾性队列研究、1项前瞻性病例对照研究和1项多中心阶梯-楔形聚类研究）。结论：一揽子和干预措施，包括旨在加强产时会阴护理的技术和工具的组合，可有效减少阴道分娩后会阴的不良后果。最常见的特征包括对分娩专业人员的培训计划，推动指导和沟通，降低分娩速度和会阴支持的动手技术，以及限制使用外阴中外侧切开术。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Efficacy of intrapartum bundles and interventions in reducing vaginal delivery-related perineal trauma: a systematic review

Objective

The aim of this systematic review is to summarize the current evidence on preventive interventions and bundles, including combinations of multiple techniques, aimed at reducing vaginal delivery-related perineal injury.

Methods

A systematic research of literature was independently conducted on different databases (PubMed, MEDLINE, EMBASE) by the authors, using a combination of the identified keywords and index terms as per current PRISMA guidelines. The research was restricted to papers published in English starting by 2000. Similar papers as previously published reviews and metanalysis satisfying the inclusion criteria were used as cross-reference to check for potential further inclusions.

Findings

In total 14 papers have been identified to be included in our review, divided into 2 randomized controlled trials and 12 cohort studies (4 prospective cohort studies, 6 retrospective cohort studies, 1 prospective case-control study and 1 multicenter step-wedge cluster study).

Conclusions

Bundles and interventions, including combinations of techniques and tools aimed at enhancing intrapartum perineal care are effective in reducing adverse perineal outcome after vaginal delivery. Most common features include training programs for labor professionals, pushing instructions and communication, hands-on technique for both reducing speed of delivery and perineal support, and restrictive use of medio-lateral episiotomy.

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来源期刊

European journal of obstetrics, gynecology, and reproductive biology 医学-妇产科学

CiteScore

4.60

自引率

3.80%

发文量

898

审稿时长

8.3 weeks

期刊介绍： The European Journal of Obstetrics & Gynecology and Reproductive Biology is the leading general clinical journal covering the continent. It publishes peer reviewed original research articles, as well as a wide range of news, book reviews, biographical, historical and educational articles and a lively correspondence section. Fields covered include obstetrics, prenatal diagnosis, maternal-fetal medicine, perinatology, general gynecology, gynecologic oncology, uro-gynecology, reproductive medicine, infertility, reproductive endocrinology, sexual medicine and reproductive ethics. The European Journal of Obstetrics & Gynecology and Reproductive Biology provides a forum for scientific and clinical professional communication in obstetrics and gynecology throughout Europe and the world.