Turawa Eunice B, Musekiwa Alfred, Rohwer Anke C
Division of Community Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa.
Cochrane Database Syst Rev. 2014 Sep 23;2014(9):CD010273. doi: 10.1002/14651858.CD010273.pub2.
Constipation is a functional bowel disorder that can reduce quality of life in the puerperium period. The diagnosis of postpartum constipation is both subjective and objective. It is characterised by symptoms such as pain or discomfort, straining, hard lumpy stools and a sense of incomplete bowel evacuation. Haemorrhoids, pain at the episiotomy site, effects of pregnancy hormones and hematinics used in pregnancy can increase the risk of postpartum constipation. Although a high fibre diet and increased fluid intake is encouraged to assist defecation in the puerperium, pain-relieving drugs and laxatives are common drugs of choice to alleviate constipation. However, the effectiveness and safety of laxatives on the nursing mother need to be ascertained.
To evaluate the effectiveness of interventions for treating postpartum constipation.
We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (28 March 2014), the metaRegister of Controlled Trials, the US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov), the Australian New Zealand Clinical Trials Registry (ANZCTR), the World Health Organization International Clinical Trials Registry platform (ICTRP), the ProQuest database, Stellenbosch University database and Google Scholar (28 March 2014). We also searched the reference lists of potentially relevant studies identified by the search, reviewed articles for relevant trials and contacted experts to identify any additional published or unpublished trials (10 April 2014).
All randomised controlled trials comparing any intervention for the treatment of postpartum constipation to another intervention, placebo or no intervention.Interventions could include laxatives, surgery, as well as educational and behavioural interventions.
Two review authors independently screened the results of the search to select potentially relevant studies using pre-designed eligibility inclusion criteria. Discrepancies were resolved through discussion. We did not identify any studies for inclusion.
We did not identify any studies that met our inclusion criteria. We excluded nine studies.
AUTHORS' CONCLUSIONS: We could not make explicit conclusions on interventions for treating postpartum constipation because we found no studies for inclusion in this review. Rigorous and well-conducted large randomised controlled trials aimed at treating postpartum women diagnosed with constipation would be beneficial. These trials should also address the criteria for administering the intervention (time and stage of a diagnosis of postpartum constipation), and the safety and effectiveness of such interventions.
便秘是一种功能性肠道疾病，会降低产褥期的生活质量。产后便秘的诊断兼具主观性和客观性。其特征包括疼痛或不适、用力排便、硬块状粪便以及排便不尽感等症状。痔疮、会阴切开部位疼痛、孕期激素的影响以及孕期使用的补血剂会增加产后便秘的风险。尽管鼓励在产褥期通过高纤维饮食和增加液体摄入量来辅助排便，但止痛药物和泻药仍是缓解便秘常用的选择药物。然而，泻药对哺乳母亲的有效性和安全性尚需确定。
评估治疗产后便秘干预措施的有效性。
我们检索了Cochrane妊娠与分娩组试验注册库（2014年3月28日）、对照试验元注册库、美国国立卫生研究院正在进行的试验注册库（ClinicalTrials.gov）、澳大利亚新西兰临床试验注册库（ANZCTR）、世界卫生组织国际临床试验注册平台（ICTRP）、ProQuest数据库、斯泰伦博斯大学数据库以及谷歌学术（2014年3月28日）。我们还检索了通过检索确定的潜在相关研究的参考文献列表，查阅相关试验的综述文章，并联系专家以确定任何其他已发表或未发表的试验（2014年4月10日）。
所有比较任何治疗产后便秘的干预措施与另一种干预措施、安慰剂或不干预的随机对照试验。干预措施可包括泻药、手术以及教育和行为干预。
两位综述作者独立筛选检索结果，使用预先设计的纳入标准选择潜在相关研究。分歧通过讨论解决。我们未确定任何纳入研究。
我们未找到任何符合纳入标准的研究。我们排除了9项研究。
由于在本综述中未找到纳入研究，我们无法就治疗产后便秘的干预措施得出明确结论。开展针对诊断为便秘的产后女性的严谨且实施良好的大型随机对照试验将有益处。这些试验还应涉及干预措施的给药标准（产后便秘诊断的时间和阶段）以及此类干预措施的安全性和有效性。
