Tan B P, Hannah M E
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Cochrane Database Syst Rev. 2000;1997(2):CD000157. doi: 10.1002/14651858.CD000157.
Induction of labour after prelabour rupture of membranes may reduce the risk of neonatal infection.
The objective of this review was to assess the effects of induction of labour with oxytocin versus expectant management for prelabour rupture of membranes at or near term (34 weeks or more).
We searched the Cochrane Pregnancy and Childbirth Group trials register.
Randomised and quasi-randomised trials of early use of oxytocin versus no early use of oxytocin for spontaneous rupture of membranes, before labour (34 weeks gestation or more).
Trials were assessed for quality and data were abstracted.
Eighteen studies were included. The trials were of variable quality with potential for significant bias. Compared to expectant management, induction of labour by oxytocin was associated with a decreased risk of maternal infection (odds ratio for chorioamnionitis of 0.63, 95% confidence interval 0.51 to 0.78, endometritis 0.72, 95% confidence interval 0.52 to 0.99). There was also a decreased risk of neonatal infection (odds ratio 0.64, 95% confidence interval 0.44 to 0.93). The size of this effect may have been biased in favour of oxytocin. Based on one trial, women were more likely to view their care positively if labour was induced with oxytocin. Caesarean section rates were not statistically different between groups, although the trend was towards fewer interventions with expectant management. Oxytocin was associated with more frequent use of pain relief and internal fetal heart rate monitoring. Perinatal mortality rates were low and not significantly different between groups, although the trend was towards fewer deaths with induction of labour by oxytocin.
REVIEWER'S CONCLUSIONS: Induction of labour by oxytocin may decrease the risk of maternal and neonatal infection compared to expectant management. Induction of labour with oxytocin does not appear to increase the rate of caesarean section, although it may increase use of pain relief and internal fetal heart rate monitoring.
胎膜早破后引产可能降低新生儿感染风险。
本综述的目的是评估在孕晚期（34周及以上）使用缩宫素引产与期待治疗对胎膜早破的效果。
我们检索了Cochrane妊娠与分娩组试验注册库。
关于在临产前（妊娠34周及以上）胎膜自然破裂时早期使用缩宫素与不早期使用缩宫素的随机和半随机试验。
评估试验质量并提取数据。
纳入18项研究。这些试验质量参差不齐，存在显著偏倚的可能性。与期待治疗相比，缩宫素引产与产妇感染风险降低相关（绒毛膜羊膜炎的比值比为0.63，95%置信区间为0.51至0.78，子宫内膜炎为0.72，95%置信区间为0.52至0.99）。新生儿感染风险也有所降低（比值比为0.64，95%置信区间为0.44至0.93）。这种效果的大小可能偏向有利于缩宫素。基于一项试验，如果使用缩宫素引产，女性更有可能对其护理给予积极评价。两组间剖宫产率无统计学差异，尽管趋势是期待治疗的干预较少。缩宫素与更频繁使用止痛药物和胎儿心率内部监测相关。围产期死亡率较低，两组间无显著差异，尽管趋势是缩宫素引产的死亡人数较少。
与期待治疗相比，缩宫素引产可能降低产妇和新生儿感染风险。缩宫素引产似乎不会增加剖宫产率，尽管它可能增加止痛药物和胎儿心率内部监测的使用。
