口服米索前列醇用于早期妊娠人工流产术前扩张宫颈的有效性和安全性评价

目的:系统评价口服米索前列醇与安慰剂比较用于孕早期人工流产术前扩张宫颈的有效性和安全性。方法:检索相关文献并行Meta分析。据异质性检验结果采用固定效应模型、敏感性分析或随机效应模型等处理。结果:纳入文献5篇688例,国外文献质量高于国内。口服米索前列醇较之安慰剂宫颈扩张度好的比例较高,可降低术中出血量及疼痛发生率;在人工流产综合征(PAAS)、胃肠道副反应和用药后腹痛发生率及手术时间上两者差异无统计学意义。结论:国内原始研究质量有待提高,结局指标需更加规范。口服米索前列醇对于扩张宫颈有较好临床效果,而在其他有效性指标方面效果不明显,其安全性有待更多证据加以评价。

Effectiveness and Safety of Oral Misoprostol for Cervical Ripening before Artificial Abortion of First-trimester Pregnancy:A Systematic Review

Objective:To evaluate the effectiveness and safety of oral misoprostol for cervical ripening before artificial abortion of the first-trimester pregnancy.Methods:Related original studies were searched and meta-analysis was conducted later.After heterogeneity test,data were pooled using fixed effect model,sensitivity analysis or randomized effect model,etc.Results:Five original trials (n=688) were found,quality of foreign studies was better than that of Chinese ones.Using oral misoprostol had a higher rate of satisfied cervical ripening when compared with placebo,the blood loss and the incidence of pain in the operation could be decreased;but regarding to the incidences of PAAS,gastrointestinal adverse reaction,abdominal pain after taking drugs and the duration of operation,there were no significant differences.Conclusions:This review showed it was important to improve the quality of Chinese original studies and standardize the outcomes.Taking orally,misoprostol had a satisfied clinical effect for ripening cervix.In other outcomes of effectiveness,the differences were not obvious.The evaluation of the safety need more proves.