摘要
目的 比较地诺前列酮和米索前列醇在足月、延期和过期妊娠中促宫颈成熟及引产效果。方法 检索CNKI、维普信息资源系统、万方数据库、Pubmed和Web of Science等多个数据库,收集关于国内地诺前列酮和米索前列醇在妊娠晚期中的引产疗效对比的临床试验研究。按照纳入及排除标准筛选出符合要求的文献并进行质量评价,并运用Stata 11.0软件进行Meta分析。结果 共筛选出符合研究要求的文献46篇,包括:地诺前列酮组3 009例,米索前列醇组2 863例。结果发现,地诺前列酮组孕产妇24 h后宫颈Bishop评分高于米索前列醇组(WMD=2.091, 95%CI:1.614, 2.568)。另外,与米索前列醇组相比,地诺前列酮组孕产妇总产程减少2.432 h(95%CI:-3.290,-1.574),临产时间减少6.979 h(95%CI:-9.162,-4.795),产后出血减少11.671 mL(95%CI:-19.507,-3.835)。地诺前列酮组孕产妇阴道分娩发生率高于米索前列醇组(RR=1.100, 95%CI:1.068, 1.134),而羊水胎粪发生率(RR=0.633,95%CI:0.483, 0.830)和胎儿窒息发生率(RR=0.515, 95%CI:0.337, 0.787)低于米索前列醇组。结论 地诺前列酮的促宫颈成熟及引产效果优于米索前列醇,但本结果需要更多临床试验进行验证。
Objective To compare the effects of dinoprostone and misoprostol for promoting cervical ripening and induction of labor in full-term,delayed pregnancy and prolonged pregnancy.Methods In this study,CNKI,VIP Information Resource System,Wanfang database,Pubmed and Web of Science and other databases were searched to collect clinical trials on the efficacy of dinoprostone and misoprostol in inducing labor in the third trimester of pregnancy among Chinese people.According to inclusion and exclusion criteria,literatures meeting the requirements were extracted,with the quality evaluated.Stata 11.0 software was used for the meta-analysis.Results A total of 46 papers meeting the requirements of the study were selected,including 3009 pregnancies in the dinoprostone group and 2863 pregnancies in the misoprostol group.It was found that the cervical Bishop score after 24 hours in the dinoprostone group was higher than that in the misoprostol group(WMD=2.091,95%CI:1.614,2.568).In addition,compared with misoprostol group,the total labor duration of dinoprostone group was reduced by 2.432 h(95%CI:-3.290,-1.574),the labor time by 6.979 h(95%CI:-9.162,-4.795),and the volume of postpartum hemorrhage by 11.671 mL(95%CI:-19.507,-3.835).The rate of vaginal delivery of pregnancies inthe dinoprostone group was higher than that of the misoprostol group(RR=1.100,95%CI:1.068,1.134).The incidence of meconium in amniotic fluid(RR=0.633,95%CI:0.483,0.830)and fetal asphyxia(RR=0.515,95%CI:0.337,0.787)in the dinoprostone group were lower than those in the misoprostol group.Conclusion Dinoprostone is better at promoting cervical ripening and induction of labor than misoprostol.However,more clinical trials are needed to confirm these results.
作者
吴琼珍
金雯
李娟
WU Qiongzhen;JIN Wen;LI Juan(Yangxin People’s Hospital,Yangxin 435200,China;The First Affiliated Hospital,Zhejiang University Medical School,Hangzhou 310003,China)
出处
《现代医院》
2023年第5期816-820,共5页
Modern Hospitals
基金
浙江省医药卫生科技项目(2020KY561)。
关键词
地诺前列酮
米索前列醇
促宫颈成熟
引产
META分析
Dinoprostone
Misoprostol
Promoting cervical ripening
Induction of labor
Meta-analysis
