Palshetkar Nandita, Purandare Ameya, Mehta Hemant, Palshetkar Rohan
Lilavati Hospital and Research Center, Mumbai, India.
Sir H N Reliance Foundation Hospital, Mumbai, India.
J Obstet Gynaecol India. 2020 Dec;70(6):425-439. doi: 10.1007/s13224-020-01343-3. Epub 2020 Aug 11.
This systematic review and meta-analysis assessed the effectiveness and safety of camylofin compared with other antispasmodics (drotaverine, hyoscine, valethamate, phloroglucinol, and meperidine) in labor augmentation. A systematic literature search until March 27, 2018, was performed, and data on the cervical dilatation rate (CDR) and duration of stages of labor reported in 39 eligible articles were analyzed using a random-effects model. CDR was significantly higher (0.38 cm/h, 95% confidence interval (CI) 0.10 to 0.67, = 0.007), and the duration of the first stage of labor was significantly shorter (- 41.21 minutes, 95% CI, - 77.19 to - 5.22, = 0.02) in women receiving camylofin than those receiving other antispasmodics for labor augmentation. CDR was significantly higher with camylofin compared with valethamate (0.6 cm/h, 95% CI 0.4 to 0.9, < 0.0001) and hyoscine (20 mg) (0.5 cm/h, 95% CI 0.1 to 0.8, = 0.02). The duration of the first stage of labor was significantly shorter with camylofin compared with hyoscine (20 mg) (- 59.9 min, 95% CI, - 117.9 to - 1.8, = 0.04). However, CDR and the duration of first stage of labor were not statistically different between camylofin and drotaverine groups. The percentage of women having nausea and vomiting, cervical/vaginal tear, and postpartum hemorrhage were comparable with all antispasmodics, whereas tachycardia was least reported in women receiving camylofin (3, 2.07%) than those receiving other antispasmodics. This meta-analysis demonstrated the benefit of camylofin in labor augmentation with a faster CDR and reduction in the active first stage of labor in Indian women.
本系统评价和荟萃分析评估了与其他解痉药（屈他维林、东莨菪碱、溴丙胺太林、间苯三酚和哌替啶）相比，卡米罗芬在引产中的有效性和安全性。进行了截至2018年3月27日的系统文献检索，并使用随机效应模型分析了39篇符合条件的文章中报告的宫颈扩张率（CDR）和产程各阶段持续时间的数据。与接受其他解痉药引产的女性相比，接受卡米罗芬的女性CDR显著更高（0.38 cm/h，95%置信区间（CI）0.10至0.67，P = 0.007），第一产程持续时间显著更短（-41.21分钟，95% CI，-77.19至-5.22，P = 0.02）。与溴丙胺太林（0.6 cm/h，95% CI 0.4至0.9，P < 0.0001）和东莨菪碱（20 mg）（0.5 cm/h，95% CI 0.1至0.8，P = 0.02）相比，卡米罗芬的CDR显著更高。与东莨菪碱（20 mg）相比，卡米罗芬的第一产程持续时间显著更短（-59.9分钟，95% CI，-117.9至-1.8，P = 0.04）。然而，卡米罗芬组和屈他维林组之间的CDR和第一产程持续时间在统计学上无差异。恶心呕吐、宫颈/阴道撕裂和产后出血的女性百分比在所有解痉药之间相当，而接受卡米罗芬的女性中报告心动过速的最少（3例，2.07%），低于接受其他解痉药的女性。这项荟萃分析证明了卡米罗芬在引产中的益处，可使印度女性的CDR更快，并缩短活跃第一产程。
