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尼日利亚埃努古地区采用膜剥脱术预防过期妊娠的随机对照试验。

Membrane stripping to prevent post-term pregnancy in Enugu, Nigeria: a randomized controlled trial.

作者信息

Ugwu Emmanuel Onyebuchi, Obi Samuel Nnamdi, Iferikigwe Eric Sunday, Dim Cyril Chukwudi, Ezugwu Frank Okechukwu

机构信息

Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Nigeria,

出版信息

Arch Gynecol Obstet. 2014 Jan;289(1):29-34. doi: 10.1007/s00404-013-2918-5. Epub 2013 Jun 14.

Abstract

OBJECTIVES

This study aimed at evaluating the effectiveness and safety of membrane stripping at 40-41 weeks of gestation as a means of preventing post-term pregnancy and the need for formal induction of labor in Enugu, Nigeria.

METHODOLOGY

A randomized controlled trial of 134 post-date pregnant women at the University of Nigeria Teaching Hospital, Enugu, Nigeria, from February to November 2012. The intervention group received membrane stripping while the control group did not receive membrane stripping.

RESULTS

The incidence of post-term pregnancy in the membrane stripping group was 16.1% (10/62) versus 39.3% (24/61) in the control group (RR 0.41; 95% CI 0.22-0.78; P = 0.004; NNT = 4). Membrane stripping reduced the duration of pregnancy by 3 days (P < 0.001). The procedure also significantly reduced the need for 'formal' labor induction [7/62 (11.3%) vs. 23/61 (37.7%); RR 0.30; 95 CI 0.14-0.65; P = 0.002]. However, maternal and neonatal complications were similar between the two groups.

CONCLUSION

Membrane stripping reduces the incidence of post-term pregnancy and need for formal induction of labor in post-date pregnant women, without increased maternal or neonatal complications.

摘要

目的

本研究旨在评估妊娠40 - 41周时行胎膜剥脱术作为预防过期妊娠及避免在尼日利亚埃努古进行正规引产的一种方法的有效性和安全性。

方法

2012年2月至11月,在尼日利亚埃努古的尼日利亚大学教学医院对134例过期妊娠孕妇进行了一项随机对照试验。干预组接受胎膜剥脱术,而对照组未接受胎膜剥脱术。

结果

胎膜剥脱术组过期妊娠的发生率为16.1%(10/62),而对照组为39.3%(24/61)(相对危险度0.41;95%可信区间0.22 - 0.78;P = 0.004;需治疗人数 = 4)。胎膜剥脱术使妊娠时长缩短了3天(P < 0.001)。该操作还显著减少了“正规”引产的需求[7/62(11.3%)对23/61(37.7%);相对危险度0.30;95%可信区间0.14 - 0.65;P = 0.002]。然而,两组之间的孕产妇和新生儿并发症相似。

结论

胎膜剥脱术可降低过期妊娠孕妇的过期妊娠发生率及正规引产的需求,且不会增加孕产妇或新生儿并发症。

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