足月妊娠晚期选择性引产安全性的Meta分析

发布时间：2018-04-26 03:16

本文选题：引产 + 足月妊娠晚期　；参考：《福建医科大学》2014年硕士论文

【摘要】：【目的】系统分析足月妊娠晚期选择性引产的母婴结局。【方法】计算机检索相关外文数据库包括：Cochrane library、PubMed、Embase、生物医学外文全文服务系统及Google学术搜索系统；同时检索相关中文数据库包括：中国生物医学文献数据库、中国知网、维普科技期刊和万方数据库。检索时间截止至2014年2月。收集足月妊娠晚期以引产结束分娩的随机对照研究，筛选文献，提取数据资料，并按Cochrane协作网推荐的方法进行系统评价，包括对入选研究进行异质性检验，数据的整合分析，敏感性分析。【结果】共纳入9项符合要求的研究，共5737人，Meta分析结果表明：对照期待治疗组，引产组羊水粪染率低且差异有统计学意义（18.18%versus25.05%，RR：0.69，95%可信区间：0.51-0.94，P=0.02）；引产组胎粪吸入率低且差异有统计学意义（1.4%versus3.2%，RR：0.44，95%可信区间：0.23-0.86，P=0.02）；其他指标：剖宫产率（21.02%versus19.48%，RR：1.07，95%可信区间：0.90-1.26， P=0.43），，新生儿窒息（1.27%versus0.83%，RR：1.43，95%可信区间：0.45-4.48，P=0.54），新生儿转新生儿重症监护室（11.41%versus12.63%，RR：0.91，95%可信区间：0.78-1.05，P=0.2），围产儿死亡率（0%versus0.22%，RR：0.29，95%可信区间：0.07-1.18，P=0.08）及新生儿出生后5分钟阿普加评分7分（0.91%versus1.27%，RR：0.73，95%可信区间：0.44-1.19，P=0.2）结果的差异无统计学意义。【结论】对妊娠时间超过41周的单胎、头位、无妊娠合并症、并发症的孕妇进行引产并未增加剖宫产、新生儿窒息、围产儿死亡等风险，而能够有效减少羊水粪染和胎粪吸入的发生。对于产前监护条件允许的医院，在正确评估风险后，对低风险足月妊娠晚期产妇可以积极引产结束妊娠，从而改善妊娠结局。
[Abstract]:Objective: to analyze the maternal and infant outcomes of selective induced labor in term pregnancy. [methods] the relevant foreign language databases were searched by computer, including: Cochrane libraryGoogle Embase, Biomedical Full-text Service system and Google academic search system, and the relevant Chinese databases included: Chinese Biomedical Literature Database, China knowledge Network. WIP Science and Technology Journal and Wanfang Database. The search time is up to February 2014. A randomized controlled study of term pregnancy ending with induced labor was collected, literature was screened, data was extracted, and systematic evaluation was carried out according to the method recommended by Cochrane Network, including heterogeneity test and data integration analysis. Sensitivity analysis [results] A total of 9 eligible studies were included, and a total of 5737 subjects were included in the meta-analysis. The feces staining rate of amniotic fluid in the induced labor group was low and the difference was statistically significant (18.18versus 25.05). There was a lower meconium uptake rate in the induced labor group with a low meconium uptake rate of 0.51-0.94 / 95%; a statistically significant difference in the meconium aspiration rate in the induced labor group; a significant difference was found in the RRv 0.4495% confidence interval 0.23-0.86%; other indicators: the cesarean section rate was 21.02versus 19.48RR1.0795% confidence interval 0.90-1.26, P0. 433,1.27versus0.8395% of the neonatal asphyxia. The confidence interval was 0.45-4.48, the newborns transferred to the neonatal intensive care unit 11.41versus 12.63N, the RR0.9195% confidence interval 0.78-1.05P0.2m, the perinatal mortality rate 0.22v RV 0.2995% confidence interval 0.07-1.18P0.08) and the Apgar score 0.91versus 1.27m at 5 minutes after birth. There was no significant difference in the results of the five minute Apgar score of 0.91 versus 1.27m and Rsquo: 0.7395% confidence interval 0.44-1.19P0.2. [conclusion] the risk of cesarean section, neonatal asphyxia and perinatal death were not increased in single pregnancy, head position, no complication and complications. It can effectively reduce the occurrence of amniotic fluid fecal staining and meconium aspiration. For the hospitals where prenatal care conditions permit, after assessing the risk correctly, the late term pregnancy at low risk can be induced to terminate the pregnancy actively, thus improving the outcome of pregnancy.
【学位授予单位】：福建医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R719.3

【参考文献】