Therapeutic Use of Hyaluronidase in Obstetrics  

作　　者：Dana Sawan Barbara Hersant Dana Sawan;Barbara Hersant(Department of Plastic, Reconstructive, Aesthetic and Maxillo-Facial Surgery, Henri Mondor University Hospital, Créteil, France)

机构地区：[1]Department of Plastic, Reconstructive, Aesthetic and Maxillo-Facial Surgery, Henri Mondor University Hospital, Créteil, France

出　　处：《Open Journal of Obstetrics and Gynecology》2021年第11期1581-1588,共8页妇产科期刊（英文）

摘　　要：Introduction: Hyaluronidases are a group of enzymes that permit greater diffusion of fluid through the tissues. These enzymes have the ability to reduce the viscosity of hyaluronic acid and increase cellular membrane and blood vessel permeability. This review discusses the indication, usage, effects, and safety of hyaluronidases in obstetrics. Materials and Methods: MEDLINE/</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">PubMed and the Cochrane Library were searched using the following terms: </span><span style="font-family:Verdana;">(“hyaluronidase” [Title/Abstract]) OR (“hyaluronidases” [Title/Abstract]) AND </span><span style="font-family:Verdana;">(“therapeutic use” [Title/Abstract]) OR (“therapeutic uses” [Title/Abstract]) OR (“perineal trauma” [Title/Abstract]) OR (“perineal tear” [Title/Abstract]) OR (“cervical ripening” [Title/Abstract]). Results: This review included four randomized controlled trials (RCT) that randomized a total of 642 pregnant women and two interventional non-RCTs that included a total of 2824 pregnant women. The data from two RCTs suggested that the incidence of perineal trauma was significantly lower in the intervention (perineal hyaluronidase injection in stage two of labor) than the control group (no intervention). However, both groups did not differ significantly in the incidence of first- and second-degree tears. Similarly, no significant difference in the incidence </span><span style="font-family:Verdana;">of episiotomy was found between both groups. In one interventional non-RCT, </span><span style="font-family:Verdana;">the administration of intracervical hyaluronidase was associated with a statistically significant acceleration and shortening of labor by approximately 1.95 hours after the injection of intracervical hyaluronidase. However, it had no effect on uterine contractions or the duration of stages two and three labor. Conclusions: While it is safe, clinicians should consider patient aIntroduction: Hyaluronidases are a group of enzymes that permit greater diffusion of fluid through the tissues. These enzymes have the ability to reduce the viscosity of hyaluronic acid and increase cellular membrane and blood vessel permeability. This review discusses the indication, usage, effects, and safety of hyaluronidases in obstetrics. Materials and Methods: MEDLINE/</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">PubMed and the Cochrane Library were searched using the following terms: </span><span style="font-family:Verdana;">(“hyaluronidase” [Title/Abstract]) OR (“hyaluronidases” [Title/Abstract]) AND </span><span style="font-family:Verdana;">(“therapeutic use” [Title/Abstract]) OR (“therapeutic uses” [Title/Abstract]) OR (“perineal trauma” [Title/Abstract]) OR (“perineal tear” [Title/Abstract]) OR (“cervical ripening” [Title/Abstract]). Results: This review included four randomized controlled trials (RCT) that randomized a total of 642 pregnant women and two interventional non-RCTs that included a total of 2824 pregnant women. The data from two RCTs suggested that the incidence of perineal trauma was significantly lower in the intervention (perineal hyaluronidase injection in stage two of labor) than the control group (no intervention). However, both groups did not differ significantly in the incidence of first- and second-degree tears. Similarly, no significant difference in the incidence </span><span style="font-family:Verdana;">of episiotomy was found between both groups. In one interventional non-RCT, </span><span style="font-family:Verdana;">the administration of intracervical hyaluronidase was associated with a statistically significant acceleration and shortening of labor by approximately 1.95 hours after the injection of intracervical hyaluronidase. However, it had no effect on uterine contractions or the duration of stages two and three labor. Conclusions: While it is safe, clinicians should consider patient a

关 键 词：HYALURONIDASE Cervical Ripening Perineal Tear Perineal Trauma Hyaluronic Acid EPISIOTOMY 

分 类 号：O17[理学—数学]