产时羊水过少预防性与治疗性羊膜腔灌注对比研究
Prophylactic versus therapeutic amnioinfusion for oligohydramnios in labour.
作者信息
Novikova Natalia, Hofmeyr G Justus, Essilfie-Appiah George
机构信息
Department of Obstetrics and Gynaecology, East London Hospital Complex, Walter Sisulu University, East London, South Africa.
出版信息
Cochrane Database Syst Rev. 2012 Sep 12;2012(9):CD000176. doi: 10.1002/14651858.CD000176.pub2.
BACKGROUND
Amnioinfusion aims to relieve umbilical cord compression during labour by infusing a liquid into the uterine cavity.
OBJECTIVES
The objective of this review was to assess the effects of prophylactic amnioinfusion for women in labour with oligohydramnios, but not fetal heart deceleration, compared with therapeutic amnioinfusion only if fetal heart rate decelerations or thick meconium-staining of the liquor occur.
SEARCH METHODS
We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (28 February 2012).
SELECTION CRITERIA
Randomised trials comparing prophylactic amnioinfusion in women in labour with oligohydramnios but not fetal heart rate deceleration in labour with therapeutic amnioinfusion.
DATA COLLECTION AND ANALYSIS
The authors assessed trial quality and extracted data.
MAIN RESULTS
One randomized trial of 116 women was included. No differences were found in the rate of caesarean section (risk ratio 1.29, 95% confidence interval 0.60 to 2.74). There were no differences in cord arterial pH, oxytocin augmentation, neonatal pneumonia or postpartum endometritis. Prophylactic amnioinfusion was associated with increased intrapartum fever (risk ratio 3.48, 95% confidence interval 1.21 to 10.05).
AUTHORS' CONCLUSIONS: There appears to be no advantage of prophylactic amnioinfusion over therapeutic amnioinfusion carried out only when fetal heart rate decelerations or thick meconium-staining of the liquor occur.
背景
羊膜腔灌注旨在通过向子宫腔内注入液体来缓解分娩期间的脐带受压。
目的
本综述的目的是评估对于羊水过少但无胎儿心率减速的分娩期妇女，预防性羊膜腔灌注与仅在出现胎儿心率减速或羊水重度胎粪污染时进行治疗性羊膜腔灌注相比的效果。
检索方法
我们检索了Cochrane妊娠和分娩小组试验注册库（2012年2月28日）。
选择标准
比较羊水过少但分娩时无胎儿心率减速的妇女进行预防性羊膜腔灌注与治疗性羊膜腔灌注的随机试验。
数据收集与分析
作者评估了试验质量并提取了数据。
主要结果
纳入了一项针对116名妇女的随机试验。剖宫产率无差异（风险比1.29，95%置信区间0.60至2.74）。脐动脉pH值、缩宫素使用增加、新生儿肺炎或产后子宫内膜炎方面均无差异。预防性羊膜腔灌注与产时发热增加相关（风险比3.48，95%置信区间1.21至10.05）。
作者结论
对于仅在出现胎儿心率减速或羊水重度胎粪污染时才进行治疗性羊膜腔灌注的情况，预防性羊膜腔灌注似乎并无优势。
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