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有过一次子宫下段剖宫产术史和无剖宫产史的孕妇在使用 PGE2 引产时子宫破裂的发生率：系统评价和荟萃分析。

Prevalence of uterine rupture among women with one prior low transverse cesarean and women with unscarred uterus undergoing labor induction with PGE2: A systematic review and meta-analysis.

机构信息

Division of Obstetrics, Department of Medical and Surgical Sciences for Mother, Child and Adult, University of Modena and Reggio Emilia, Modena, Italy.

Statistics Unit, Department of Diagnostic and Clinical Medicine and Public Health, University of Modena and Reggio Emilia, Modena, Italy.

出版信息

PLoS One. 2021 Jul 6;16(7):e0253957. doi: 10.1371/journal.pone.0253957. eCollection 2021.

DOI:10.1371/journal.pone.0253957
PMID:34228760
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8259955/
Abstract

BACKGROUND

As uterine rupture may affect as many as 11/1000 women with 1 prior cesarean birth and 5/10.000 women with unscarred uterus undergoing labor induction, we intended to estimate the prevalence of such rare outcome when PGE2 is used for cervical ripening and labor induction.

METHODS

We searched MEDLINE, ClinicalTrials.gov and the Cochrane library up to September 1st 2020. Retrospective and prospective cohort studies, as well as randomized controlled trials (RCTs) on singleton viable pregnancies receiving PGE2 for cervical ripening and labor induction were reviewed. Prevalence of uterine rupture was meta-analyzed with Freeman-Tukey double arcsine transformation among women with 1 prior low transverse cesarean section and women with unscarred uterus.

RESULTS

We reviewed 956 full text articles to include 69 studies. The pooled prevalence rate of uterine rupture is estimated to range between 2 and 9 out of 1000 women with 1 prior low transverse cesarean (5/1000; 95%CI 2-9/1000, 122/9000). The prevalence of uterine rupture among women with unscarred uterus is extremely low, reaching at most 0.7/100.000 (<1/100.000.000; 95%CI <1/100.000.000-0.7/100.000, 8/17.684).

CONCLUSIONS

Uterine rupture is a rare event during cervical ripening and labor induction with PGE2.

摘要

背景

由于子宫破裂可能影响多达 11/1000 名有 1 次剖宫产史的妇女和 5/10000 名无瘢痕子宫行引产的妇女，我们旨在估计当 PGE2 用于宫颈成熟和引产时这种罕见结局的发生率。

方法

我们检索了 MEDLINE、ClinicalTrials.gov 和 Cochrane 图书馆，截至 2020 年 9 月 1 日。回顾了接受 PGE2 进行宫颈成熟和引产的单胎活胎妊娠的回顾性和前瞻性队列研究以及随机对照试验（RCT）。对有 1 次低位横切口剖宫产史的妇女和无瘢痕子宫的妇女，采用 Freeman-Tukey 双反正弦变换进行荟萃分析，以评估子宫破裂的发生率。

结果

我们查阅了 956 篇全文文章，纳入了 69 项研究。子宫破裂的总体发生率估计在有 1 次低位横切口剖宫产史的妇女中为 2 至 9/1000（5/1000；95%CI 2-9/1000，122/9000）。无瘢痕子宫妇女子宫破裂的发生率极低，最多为 0.7/100000（<1/100000000；95%CI <1/100000000-0.7/100000，8/17684）。

结论

在使用 PGE2 进行宫颈成熟和引产时，子宫破裂是一种罕见事件。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/56c0/8259955/f71a4594db93/pone.0253957.g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/56c0/8259955/fce5eadff80f/pone.0253957.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/56c0/8259955/00cd6b6db9a6/pone.0253957.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/56c0/8259955/e0b2d2155fe9/pone.0253957.g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/56c0/8259955/f71a4594db93/pone.0253957.g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/56c0/8259955/fce5eadff80f/pone.0253957.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/56c0/8259955/00cd6b6db9a6/pone.0253957.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/56c0/8259955/e0b2d2155fe9/pone.0253957.g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/56c0/8259955/f71a4594db93/pone.0253957.g004.jpg

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