目的:评估普萘洛尔对引产或延长分娩时间的影响。
方法:PubMed,Scopus,科克伦图书馆,ClinicalTrials.gov,和CINAHL(EBSCO)从开始到2023年12月进行了搜索。
方法:研究普萘洛尔对接受引产或延长分娩的患者分娩时间的影响的随机对照试验(RCT)。随机分组前包括死产的随机对照试验,非随机试验,观察,队列,案例控制,或对照组包括标准治疗以外的干预措施的研究被排除.
方法:主要结局是在接受引产或增加分娩的患者中给予普萘洛尔后的分娩时间。汇总措施报告为汇总平均差(MD)或相对风险,置信区间为95%(CI)。
结果:本荟萃分析纳入了9项随机对照试验,包括1,182例患者。五项研究调查了普萘洛尔在接受引产(IOL)的患者中的作用,并证明了分娩时间的显着减少(MD,-91.5分钟,95%CI-110.6至-72.4)。四项研究调查了普萘洛尔在接受分娩的患者中的作用,并且显示分娩时间没有显着减少(MD,-2.98分钟,95%CI-21.6至15.6)。我们的汇总分析表明,与安慰剂相比,在IOL和增强术中使用普萘洛尔与服用普萘洛尔的分娩时间减少有关(平均差异,-46.15分钟,95%CI-59.48至-32.81)。荟萃分析发现PPH的风险没有增加,输血,剖宫产率,或在分娩期间使用普萘洛尔入院NICU。
结论:在引产期间使用普萘洛尔可将分娩的总时间缩短约91分钟,而在那些接受分娩的患者中,并没有显著缩短分娩时间。
OBJECTIVE: To assess the effect of propranolol on time to delivery among patients undergoing induction or augmentation of
labor.
METHODS: PubMed, Scopus, Cochrane Library, ClinicalTrials.gov, and CINAHL (EBSCO) were searched from inception to December 2023.
METHODS: Randomized controlled trials (RCTs) that examined the impact of propranolol on time to delivery among patients undergoing induction or augmentation of
labor were included. RCTs that included stillbirth before randomization, non-randomized trials, observational, cohort, case control, or studies in which the control group included an intervention other than standard care were excluded.
METHODS: Primary outcome was time to delivery after administration of propranolol among patients undergoing induction or augmentation of
labor. The summary measures were reported as summary mean difference (MD) or relative risk with 95% of confidence interval (CI).
RESULTS: Nine RCTs including 1,182 patients were included in this meta-analysis. Five studies investigated the effect of propranolol among patients undergoing induction of
labor (IOL) and demonstrated a significant decrease in time to delivery (MD, -91.5 minutes, 95% CI -110.6 to -72.4). Four studies investigated the effect of propranolol among patients undergoing augmentation of
labor and showed no significant decrease in time to delivery (MD, -2.98 minutes, 95% CI -21.6 to 15.6). Our pooled analysis demonstrated that the use of propranolol in IOL and augmentation was associated with a decrease in time to delivery from administration of propranolol compared to placebo (mean difference, -46.15 minutes, 95% CI -59.48 to -32.81). The meta-analysis found no increased risk of PPH, blood transfusion, cesarean delivery rates, or NICU admission with the use of propranolol during labor.
CONCLUSIONS: The use of propranolol during induction of labor shortens overall time to delivery by about 91 minutes and did not significantly decrease time to delivery in those undergoing augmentation of labor.