目的:这篇综合文献综述概述了目前筛查和诊断女性绒毛膜羊膜炎的最佳研究证据。因为目前没有进行审查。概述筛查和诊断妇女绒毛膜羊膜炎的最佳做法可以帮助助产士准确诊断。允许早期转诊和适当管理这种感染。
方法:通过EBSCOhost(CINAHL与全文,电子书收藏,健康来源:护理学/学术版,MEDLINE,开放式论文和PsycINFO),Cochrane在线,PubMed,Scopus,然后使用Google和引文搜索手动搜索灰色文献。指导方针,研究,从2008年到2020年与绒毛膜羊膜炎相关的英文报告被纳入研究。
结果:经过严格的评估,使用JoannaBriggs机构的清单,定量研究研究评估工具和研究评估工具指南评估,共包括31篇文章。超过一半(64%)的文献包括排名在三个最高水平的证据(一级,II和III)。关于女性绒毛膜羊膜炎筛查和诊断的数据被合成为四个主题,即:通过临床体征和症状进行筛查,通过绒毛膜羊膜炎的致病因素筛查,产科病史筛查,和必要的生物标志物来诊断绒毛膜羊膜炎。
结论:筛查和记录任何危险因素将有助于助产士提供量身定制的健康教育,以预防可能导致绒毛膜羊膜炎的致病因素。尽管基质金属蛋白酶-8(MMP-8)似乎是最适合用于筛查的测试,绒毛膜羊膜炎的准确诊断需要结合筛查方法和测试,如临床体征和症状,母体生物标志物,羊水测试和组织学。绒毛膜羊膜炎筛查,特别是作为绒毛膜羊膜炎临床症状的产妇发热参数,绒毛膜羊膜炎的促成因素和微生物,MMP-8的可用性和快速的发展,便宜,用于绒毛膜羊膜炎筛查和诊断的易于使用的技术,值得进一步研究。
结论:助产士可以将这些结果用于筛查和诊断妇女绒毛膜羊膜炎,以便在孕产妇和新生儿并发症出现之前进行早期转诊和充分管理。
OBJECTIVE: This integrative literature
review provides an overview of current best research evidence on the screening and diagnosis of women for chorioamnionitis, as no current
review has been conducted. An overview of best practices on screening and diagnosis of women for chorioamnionitis can assist midwives with an accurate diagnosis, allowing for early referral and adequate management of this infection.
METHODS: An integrative literature
review was conducted using a systematic electronic literature search through EBSCOhost (CINAHL with Full Text, e-Book Collection, Health Source: Nursing/Academic Edition, MEDLINE, Open Dissertations and PsycINFO), Cochrane Online, PubMed, Scopus, followed by a manual search for grey literature using Google and a citation search. Guidelines, research studies, and reports in English related to chorioamnionitis from 2008 up until 2020 were included in the study.
RESULTS: After critical appraisal, using the Joanna Briggs Institution\'s checklists, Evaluation Tool for Quantitative Research Studies\' tool and the Appraisal of Guidelines for Research & Evaluation instrument, 31 articles were included. More than half (64%) of the literature included ranked on the three highest levels of evidence (Level I, II and III). Data extracted regarding screening and diagnosis of women for chorioamnionitis was synthesised into four themes, namely: screening by clinical signs and symptoms, screening by causative factors of chorioamnionitis, screening of obstetric history, and essential biomarkers to diagnose chorioamnionitis.
CONCLUSIONS: Screening and recording of any risk factors will assist midwives in providing tailored health education to possibly prevent causative factors that could lead to chorioamnionitis. Although matrix-metalloproteinase-8 (MMP-8) seems the most suitable test to use for screening, an accurate diagnosis of chorioamnionitis requires a combination of screening methods and tests, such as clinical signs and symptoms, maternal biomarkers, amniotic fluid testing and histology. Screening for chorioamnionitis, particularly the parameters for maternal fever as a clinical symptom of chorioamnionitis, contributing factors and microbes responsible for chorioamnionitis, the usability of MMP-8 and the development of rapid, inexpensive, easy-to-use techniques for screening and diagnosis of chorioamnionitis, warrants further research.
CONCLUSIONS: Findings can be used by midwives in the screening and diagnosis of women for chorioamnionitis which allows for early referral and adequate management before maternal and neonatal complications arise.