低分子肝素治疗妊娠中晚期羊水过少临床效果Meta分析

The clinical effects of low molecular heparin on oligohydramnios in middle and later pregnancy:a Meta-analysis

目的系统评价低分子肝素治疗妊娠中晚期羊水过少的临床效果。方法检索PubMed、Cochrane Library、Embase、维普中文科技期刊数据库、万方数据库和中国知网(CNKI),收集从建库至2018年9月发表的关于低分子肝素治疗羊水过少的随机对照试验(RCT),进行文献筛选及纳入文献质量评价,采用RevMan 5.3软件行Meta分析。结果共纳入18篇文献,1572例孕妇符合纳入标准。Meta分析结果表明,肝素治疗组与常规水化治疗组比较,肝素治疗组在羊水指数(AFI)、脐动脉血流阻力(S/D)、剖宫产率、新生儿窒息率、新生儿体重方面均明显优于常规水化治疗组,差异有统计学意义;产后出血发生率差异无显著性。结论低分子肝素治疗妊娠中晚期羊水过少疗效确切且安全,有利于改善母婴结局,值得临床推广。

Objective To systematically evaluate the clinical effects of low molecular heparin on oligohydramnios in middle and later pregnancy.Methods The database of PubMed,Cochrane Library,Embase,Wanfang,VIP and CNKI were searched from inception to Sep 2018.Randomized controlled trials for the treatment of oligohydramnios with low molecular heparin were evaluated.Meta analysis was carried out with RevMan 5.3 software.Results A total of 18 articles were included,1572 gravidas were eligible and included in the systematic review.The results of Meta analysis showed that AFI,S/D,cesarean section rate,neonatal asphyxia rate and neonatal weight in heparin treatment group were significantly better than that in hydration therapy group.There was no significant difference in incidence of postpartum hemorrhage.Conclusion Low molecular heparin is effective and safe in the treatment of oligohydramnios in middle and later pregnancy,and it is conducive to improving maternal and infant outcomes,so it is worth being popularized.