Midwifery Department, Tabriz University of Medical sciences, Tabriz, Iran.
Student Research Committee, Tabriz Branch, Islamic Azad University, Tabriz, Iran.
J Obstet Gynaecol. 2022 Aug;42(6):1669-1678. doi: 10.1080/01443615.2022.2069001. Epub 2022 Jun 2.
This study assessed the effect of dexamethasone on labour induction, Bishop Score, mean intervals from induction of labour to the active phase and delivery, duration of first and second stages of labour and caesarean section frequency. A search was carried out in PubMed, Cochrane Library, Embase, Ovid, Scopus, ClinicalTrials.gov, Google Scholar and Persian databases. The quality of studies was evaluated using Cochrane handbook and the meta-analysis was conducted in RevMan 5.3. The heterogeneity of the studies was assessed using , and . Subgroup analysis was used based on the routes of drug administration. Quality of evidence was assessed using the GRADE approach. 10 studies were included. The results showed significant differences between dexamethasone and control groups in terms of the mean interval from induction of labour to the active phase ( = -1.55), Bishop score ( = 2.40), duration of second stage of labour ( = -8.61) and interval from induction of labour to delivery ( = -2.83). There were no significant differences in duration of first stage of labour (= -0.69) and caesarean section frequency ( = 1.09). Dexamethasone reduces the time interval between induction and delivery and also accelerates labour through cervical ripening and Bishop Score improvements.IMPACT STATEMENT Labour induction is a common obstetrics procedure. The desirable condition of the cervix, measured by the Bishop score, is a key to the successful induction. Several mechanical and biomechanical methods are used to achieve desirable cervical ripeness. The role of corticosteroids in the delivery process has not been well demonstrated. The meta-analysis results showed significant differences between dexamethasone and control groups in terms of the mean interval from induction of labour to the active phase. According to the evidences, dexamethasone can be used to reduce the interval between induction to active phase.
本研究评估了地塞米松对引产、Bishop 评分、从引产到活跃期和分娩的平均间隔时间、第一产程和第二产程的持续时间以及剖宫产率的影响。在 PubMed、Cochrane 图书馆、Embase、Ovid、Scopus、ClinicalTrials.gov、Google Scholar 和 Persian 数据库中进行了检索。使用 Cochrane 手册评估研究质量，并使用 RevMan 5.3 进行荟萃分析。使用 和 评估研究的异质性。根据药物给药途径进行亚组分析。使用 GRADE 方法评估证据质量。纳入 10 项研究。结果显示，地塞米松组与对照组在从引产到活跃期的平均间隔时间（ = -1.55）、Bishop 评分（ = 2.40）、第二产程持续时间（ = -8.61）和从引产到分娩的间隔时间（ = -2.83）方面存在显著差异。第一产程持续时间（ = -0.69）和剖宫产率（ = 1.09）无显著差异。地塞米松可减少引产至分娩的时间间隔，并通过宫颈成熟和 Bishop 评分改善加速分娩。
IMPACT 陈述：
引产是一种常见的产科程序。宫颈的理想状态，用 Bishop 评分来衡量，是引产成功的关键。有几种机械和生物力学方法用于达到理想的宫颈成熟度。皮质类固醇在分娩过程中的作用尚未得到很好的证明。荟萃分析结果显示，地塞米松组与对照组在从引产到活跃期的平均间隔时间方面存在显著差异。根据这些证据，地塞米松可用于缩短引产至活跃期的间隔时间。
