Begley Cecily M, Gross Mechthild M, Dencker Anna, Benstoem Carina, Berg Marie, Devane Declan
School of Nursing and Midwifery, Trinity College Dublin, 24 D׳Olier St, Dublin 2, Ireland.
Midwifery Research and Education Unit, Department of Obstetrics, Gynaecology and Reproductive Medicine, Hannover Medical School, Hannover, Germany.
Midwifery. 2014 Sep;30(9):975-82. doi: 10.1016/j.midw.2014.06.005. Epub 2014 Jul 1.
to identify primary and secondary outcome measures in randomised trials, and systematic reviews of randomised trials, measuring effectiveness of oxytocin for treatment of delay in the first and second stages of labour, and to identify any positive health-focussed outcomes used.
eight relevant citation databases were searched up to January 2013 for all randomised trials, and systematic reviews of randomised trials, measuring effectiveness of oxytocin for treatment of delay in labour. Trials of active management of labour or partogram action lines were excluded. 1918 citations were identified. Two reviewers reviewed all citations and extracted data. Twenty-six individual trials and five systematic reviews were included. Primary and secondary outcome measures were documented and analysed using frequency distributions.
most frequent primary outcomes were caesarean section (n=15, 46%), length of labour (n=14, 42%), measurements of uterine activity (n=13, 39%) and mode of vaginal birth (n=9, 27%). Maternal satisfaction was identified a priori by one review and included as a secondary outcome by three papers. No further positive health-focussed outcomes were identified.
outcomes used to measure the effectiveness of oxytocin for treatment of delay in labour are heterogeneous and tend to focus on adverse events.
it is recommended that, in future randomised trials of oxytocin use for delay in labour, some women-centred and health-focussed outcome measures should be used, which may instil a more salutogenic culture in childbirth.
确定随机试验以及随机试验的系统评价中的主要和次要结局指标，这些试验和评价旨在衡量催产素治疗第一产程和第二产程产程延长的有效性，并确定所使用的任何以健康为重点的积极结局。
检索了8个相关的文献数据库，截至2013年1月，查找所有衡量催产素治疗产程延长有效性的随机试验以及随机试验的系统评价。排除了活跃期管理或产程图行动线的试验。共识别出1918篇文献。两名评审员对所有文献进行了评审并提取数据。纳入了26项个体试验和5项系统评价。使用频率分布记录并分析主要和次要结局指标。
最常见的主要结局是剖宫产（n = 15，46%）、产程长度（n = 14，42%）、子宫活动测量（n = 13，39%）和阴道分娩方式（n = 9，27%）。一项评价事先确定了产妇满意度，并被三篇论文列为次要结局。未发现其他以健康为重点的积极结局。
用于衡量催产素治疗产程延长有效性的结局指标具有异质性，且往往侧重于不良事件。
建议在未来关于催产素用于产程延长的随机试验中，应使用一些以女性为中心且以健康为重点的结局指标，这可能会在分娩过程中营造一种更注重健康促进的文化。
