Abou-Dakn Michael, Schäfers Rainhild, Peterwerth Nina, Asmushen Kirsten, Bässler-Weber Susanne, Boes Ulrike, Bosch Andrea, Ehm David, Fischer Thorsten, Greening Monika, Hartmann Katharina, Heller Günther, Kapp Claudia, von Kaisenberg Constantin, Kayer Beate, Kranke Peter, Lawrenz Burkhard, Louwen Frank, Loytved Christine, Lütje Wolf, Mattern Elke, Nielsen Renate, Reister Frank, Schlösser Rolf, Schwarz Christiane, Stephan Volker, Kalberer Barbara Stocker, Valet Axel, Wenk Manuel, Kehl Sven
Klinik für Gynäkologie und Geburtshilfe, St. Joseph Krankenhaus, Berlin-Tempelhof, Berlin, Germany.
Hochschule für Gesundheit Department für Angewandte Gesundheitswissenschaften Bochum, Bochum, Germany.
Geburtshilfe Frauenheilkd. 2022 Nov 3;82(11):1194-1248. doi: 10.1055/a-1904-6769. eCollection 2022 Nov.
This guideline aims to summarize the current state of knowledge about vaginal birth at term. The guideline focuses on definitions of the physiological stages of labor as well as differentiating between various pathological developments and conditions. It also assesses the need for intervention and the options to avoid interventions. The second part of this guideline presents recommendations and statements on care during the dilation and expulsion stages as well as during the placental/postnatal stage. The German recommendations largely reproduce the recommendations of the National Institute for Health and Care Excellence (NICE) CG190 guideline "Intrapartum care for healthy women and babies". Other international guidelines were also consulted in individual cases when compiling this guideline. In addition, a systematic search and analysis of the literature was carried out using PICO questions where necessary, and other systematic reviews and individual studies were taken into account. For easier comprehension, the assessment tools of the Scottish Intercollegiate Guidelines Network (SIGN) were used to evaluate the quality of additionally consulted studies. Otherwise, the GRADE system was used for the NICE guideline, and the evidence reports of the IQWiG were used to evaluate the quality of the evidence. Recommendations and statements were formulated based on identified evidence and/or a structured consensus.
本指南旨在总结足月阴道分娩的当前知识状况。该指南侧重于分娩生理阶段的定义，以及区分各种病理发展和情况。它还评估了干预的必要性以及避免干预的选择。本指南的第二部分提出了关于宫颈扩张期、胎儿娩出期以及胎盘/产后阶段护理的建议和声明。德国的建议在很大程度上重现了英国国家卫生与临床优化研究所（NICE）CG190指南“健康妇女和婴儿的产时护理”中的建议。在编写本指南时，个别情况下也参考了其他国际指南。此外，必要时使用PICO问题对文献进行了系统检索和分析，并考虑了其他系统评价和个别研究。为便于理解，使用了苏格兰跨学院指南网络（SIGN）的评估工具来评估额外查阅研究的质量。否则，对于NICE指南使用GRADE系统，对于证据质量的评估则使用了德国卫生质量与效率研究所（IQWiG）的证据报告。建议和声明是根据已确定的证据和/或结构化共识制定的。
