Do mechanical methods of cervical ripening increase infectious morbidity? A systematic review
Do mechanical methods of cervical ripening increase infectious morbidity? A systematic review
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DOI：
10.1016/j.ajog.2008.05.005
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发表时间：
2008-08-01
影响因子：
9.8
通讯作者：
Kaunitz, Andrew M.
中科院分区：
文献类型：
--
作者：
Heinemann, Jennifer;Gillen, Geoff;Kaunitz, Andrew M.
本研究的目的是系统地回顾与宫颈成熟相关的随机对照试验。我们确定了随机对照试验，比较了Foley导管、羊膜外生理盐水输注、海带或吸湿性扩张器用于宫颈成熟或使用药物或安慰剂诱导的情况。选择了评估母体或新生儿感染的随机对照试验。评估的结果是母婴感染、绒毛膜羊膜炎和子宫肌炎。30项研究符合纳入标准。与单纯使用药物方法相比，使用机械剂进行宫颈成熟的患者的母体感染率明显更高。与药物相比，单独使用Foley导管进行催熟的患者也有类似的结果。在接受羊膜外生理盐水输注、海带或吸湿性扩张器成熟的患者中，母亲感染率没有差异。与单独使用药物相比，当使用机械药物进行宫颈成熟时，孕产妇和新生儿感染发病率似乎增加。
The purpose of this study was to review systematically randomized controlled trials that were associated with cervical ripening. We identified randomized controlled trials that compared the use of Foley catheter, with or without extraamniotic saline solution infusion, Laminaria, or hygroscopic dilators for cervical ripening or induction with pharmacologic agents or placebo. Randomized controlled trials that evaluated maternal or neonatal infection were selected. The outcomes that were assessed were maternal and neonatal infection, chorioamnionitis, and endomyometritis. Thirty studies met inclusion criteria. Compared with the use of pharmacologic methods alone, patients who underwent cervical ripening with mechanical agents had a significantly higher rate of maternal infection rates. Similar results were noted for patients who underwent ripening with Foley catheter alone in comparison with pharmacologic agents. No difference was noted in maternal infection rates for patients who underwent ripening with extraamniotic saline solution infusion, Laminaria, or hygroscopic dilators. Compared with the use of pharmacologic agents alone, maternal and neonatal infectious morbidity appears to be increased when mechanical agents are used for cervical ripening.