水中分娩对产妇及新生儿影响的系统评价  

Maternal and Obstetrical Outcomes of Birth in Water:A Systematic Review

作　　者：高琦[1,2] 张佩珍[3] 高明霞[1,2] 杨克虎[1,2] 田金徽[1,2] 

机构地区：[1]兰州大学循证医学中心,兰州730000 [2]兰州大学第一临床医学院,兰州730000 [3]兰州市妇幼保健院,兰州730000

出　　处：《中国循证医学杂志》2009年第8期832-839,共8页Chinese Journal of Evidence-based Medicine

基　　金：兰州大学循证医学中心“循证医学本科生教学创新基金”(2008LDEBM-B);兰州大学创新创业行动计划项目

摘　　要：目的系统评价水中分娩技术的有效性和安全性。方法计算机检索中文科技期刊全文数据库、中国期刊全文数据库、数字化期刊全文数据库、中国生物医学文献数据库、PubMed、EMbase、SCI和CochraneLibrary,并辅以其它检索,纳入水中分娩与传统分娩方式比较的随机对照试验,由两位评价者进行资料提取和质量评价后,采用RevMan5.0软件进行Meta分析。结果共纳入11个研究,包括3963例产妇。Meta分析结果显示:水中分娩在会阴侧切率[OR=0.09,95%CI(0.01,-0.59)]和失血量[MD=-36.02,95%CI(-55.24,-16.79)]方面低于普通分娩方式;而在镇痛效果、会阴裂伤、产程及母儿结局方面,两者间差异无统计学意义。结论现有证据表明,与传统分娩相比,水中分娩能有效降低产妇会阴侧切率及减少出血,而不会对母儿安全造成新的风险。对于其他方面的评价,尚需要更多研究进一步证实。Objective To compare maternal and obstetrical outcomes of water birth and land birth. Methods We searched PubMed, EMbase, SCI, The Cochrane Library, Chinese Biomedical Literature Database, China Journal Full Text Database, Chinese Scientific Journals Full Text Database, conference proceedings, and references of the included studies to identify randomized controlled trials （RCTs） comparing water birth and land birth. The methodological quality was evaluated and the data was extracted by two reviewers independently using a designed extraction form. The Cochrane Collaboration＇s RevMan 5.0 software was used to carry out meta-analyses. Results Eleven RCTs involving 3963 lying-in women were included. The results of meta-analysis showed that the rate of episiotomy （OR=0.09, 95%CI 0.01 to -0.59） and estimated blood loss （MD= -36.02, 95% -55.24 to -16.79） in the immersion group were significantly lower than those in the non-immersion group. There were no significant differences between the two groups on the other sides of the study. Conclusion Water birth can reduce the rate of episiotomy and estimated blood loss during the duration of labor. And there is no more risk of maternal and neonatal infection. More high-quality randomized controlled trials are required.

关 键 词：水中分娩 系统评价 META分析 

分 类 号：R714.3[医药卫生—妇产科学] R-37[医药卫生—临床医学]