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熊去氧胆酸改善妊娠期肝内胆汁淤积症患者的妊娠结局:系统评价和荟萃分析方案。

Ursodeoxycholic acid improves pregnancy outcome in patients with intrahepatic cholestasis during pregnancy: A protocol for systematic review and meta-analysis.

机构信息

Department of Gastroenterology, Boai Hospital of Zhongshan Affiliated to Southern Medical University, Zhongshan.

Reproductive and Genetic Medicine Center, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong province, China.

出版信息

Medicine (Baltimore). 2021 Jan 29;100(4):e23627. doi: 10.1097/MD.0000000000023627.

Abstract

BACKGROUND

Intrahepatic cholestasis of pregnancy (ICP) is a common complication in the third trimester of pregnancy, which may result in premature delivery, fetal distress, stillbirth, and other adverse pregnancy outcomes. Ursodeoxycholic acid (UDCA) is a first-line treatment for ICP and has been controversial in improving adverse pregnancy outcomes. The purpose of this protocol is to systematically evaluate the effect of UDCA on pregnancy outcomes in patients with intrahepatic cholestasis during pregnancy.

METHODS

To search the databases PubMed, Embase, Web of Science, the Cochrane Library, CNKI, WanFang, VIP, CBMDIsc by computer, then to include randomized controlled clinical studies on UDCA for treatment of intrahepatic cholestasis during pregnancy from the establishment of the database to October 1, 2020. Two researchers independently extract and evaluate the data of the included studies, and meta-analysis is conducted on the included literatures using RevMan5.3 software.

RESULTS

This protocol evaluates the outcome of UDCA in improving ICP by incidence of postpartum hemorrhage in pregnant women preterm birth rates meconium contamination rate in amniotic fluid incidence of fetal distress scale of newborns scoring <7 in 5-min Apgar incidence of neonatal admission to neonatal intensive care unit.

CONCLUSION

This protocol will provide an evidence-based basis for clinical use of UDCA in the treatment of intrahepatic cholestasis during pregnancy.

ETHICS AND DISSEMINATION

Private information from individuals will not be published. This systematic review also does not involve endangering participant rights. Ethical approval was not required. The results may be published in a peer-reviewed journal or disseminated at relevant conferences.

OSF REGISTRATION NUMBER

DOI 10.17605 / OSF.IO / BE67H.

摘要

背景

妊娠肝内胆汁淤积症(ICP)是妊娠晚期的一种常见并发症,可能导致早产、胎儿窘迫、死产和其他不良妊娠结局。熊去氧胆酸(UDCA)是治疗 ICP 的一线药物,但在改善不良妊娠结局方面存在争议。本方案旨在系统评价 UDCA 对妊娠期肝内胆汁淤积症患者妊娠结局的影响。

方法

通过计算机检索 PubMed、Embase、Web of Science、Cochrane 图书馆、中国知网、万方、维普及中国生物医学文献数据库,从建库起至 2020 年 10 月 1 日,收集 UDCA 治疗妊娠期肝内胆汁淤积症的随机对照临床研究。由 2 位研究者独立提取和评价纳入研究的数据,并采用 RevMan5.3 软件进行 Meta 分析。

结果

本方案评价 UDCA 改善 ICP 的结局指标包括孕妇产后出血发生率、早产儿出生率、羊水胎粪污染率、新生儿 5 分钟 Apgar 评分<7 分发生率、新生儿入住新生儿重症监护病房率。

结论

本方案将为 UDCA 治疗妊娠期肝内胆汁淤积症的临床应用提供循证医学依据。

伦理与传播

本方案不会公布个人的隐私信息。本系统评价也不会危害参与者的权利。本研究无需伦理批准。研究结果可能会发表在同行评议的期刊上,或在相关会议上传播。

OSF 注册号:DOI 10.17605/OSF.IO/BE67H。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf1f/7850722/ec67475232f7/medi-100-e23627-g001.jpg

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