摘要

BACKGROUND: At present, there is insufficient evidence to guide appropriate management of women with preterm prelabor rupture of membranes (PPROM) near term. METHODS AND FINDINGS: We conducted an open-label randomized controlled trial in 60 hospitals in The Netherlands, which included non-laboring women with >24 h of PPROM between 34(+0) and 37(+0) wk of gestation. Participants were randomly allocated in a 1:1 ratio to induction of labor (IoL) or expectant management (EM) using block randomization. The main outcome was neonatal sepsis. Secondary outcomes included mode of delivery, respiratory distress syndrome (RDS), and chorioamnionitis. Patients and caregivers were not blinded to randomization status. We updated a prior meta-analysis on the effect of both interventions on neonatal sepsis, RDS, and cesarean section rate. From 1 January 2007 to 9 September 2009, 776 patients in 60 hospitals were eligible for the study, of which 536 patients were randomized. Four patients were excluded after randomization. We allocated 266 women (268 neonates) to IoL and 266 women (270 neonates) to EM. Neonatal sepsis occurred in seven (2.6%) newborns of women in the IoL group and in 11 (4.1%) neonates in the EM group (relative risk [RR] 0.64; 95% confidence interval [CI] 0.25 to 1.6). RDS was seen in 21 (7.8%, IoL) versus 17 neonates (6.3%, EM) (RR 1.3; 95% CI 0.67 to 2.3), and a cesarean section was performed in 36 (13%, IoL) versus 37 (14%, EM) women (RR 0.98; 95% CI 0.64 to 1.50). The risk for chorioamnionitis was reduced in the IoL group. No serious adverse events were reported. Updating an existing meta-analysis with our trial results (the only eligible trial for the update) indicated RRs of 1.06 (95% CI 0.64 to 1.76) for neonatal sepsis (eight trials, 1,230 neonates) and 1.27 (95% CI 0.98 to 1.65) for cesarean section (eight trials, 1,222 women) for IoL compared with EM. CONCLUSIONS: In women whose pregnancy is complicated by late PPROM, neither our trial nor the updated meta-analysis indicates that IoL substantially improves pregnancy outcomes compared with EM. TRIAL REGISTRATION: Current Controlled Trials ISRCTN29313500

译文

背景: 目前,没有足够的证据指导早产前胎膜早破 (PPROM) 妇女的适当管理。方法和结果: 我们在荷兰的 60 家医院进行了一项开放标签随机对照试验,其中包括 34 (0) 例 PPROM> 24 小时的非劳动妇女和妊娠 37 (0) 周。参与者以 1:1 的比例随机分配到引产 (IoL) 或使用分组随机化的期待管理 (EM)。主要结局是新生儿败血症。次要结局包括分娩方式、呼吸窘迫综合征 (RDS) 和绒毛膜羊膜炎。患者和护理人员对随机化状态不视而不见。我们更新了关于两种干预措施对新生儿败血症、 RDS 和剖腹产率影响的先前荟萃分析。从 2007年1月1日到 2009年9月9日,60 家医院的 776 名患者有资格参加这项研究,其中 536 名患者是随机的。随机分组后排除 4 例患者。我们分配了 266 名女性 (268 名新生儿) 用于人工晶状体,266 名女性 (270 名新生儿) 用于 EM。新生儿败血症发生在人工晶状体组的 7 例 (2.6%) 女性新生儿和 EM 组的 11 例 (4.1%) 新生儿 (相对风险 [RR] 0.64; 95% 置信区间 [CI] 0.25 至 1.6)。RDS 在 21 例 (7.8%,IoL) 和 17 例新生儿 (6.3%,EM) 中出现 (RR 1.3; 95% CI 0.67 到 2.3),并且在 36 例 (13%, ioL) 对 37 (14%,EM) 女性 (RR 0.98; 95% CI 0.64 至 1.50)。人工晶状体组绒毛膜羊膜炎的风险降低。无严重不良事件报告。用我们的试验结果 (唯一符合更新条件的试验) 更新现有的荟萃分析表明,新生儿败血症 (8 项试验,1.06 例新生儿) 的 RRs 为 95% (0.64 CI 1.76 至 1,230) 和 1.27 (95% CI 0.98 至 1.65) 的剖宫产术 (8 项试验,1,222 名妇女)IoL 与 EM 比较。结论: 在妊娠并发晚期 PPROM 的妇女中,无论是我们的试验还是更新的荟萃分析都表明,与 EM 相比,IoL 显著改善了妊娠结局。试验登记: 当前对照试验 ISRCTN29313500

labor induction

妇产 终止妊娠 手术操作
概述  :  

引产指的是女性在怀孕12周之后,因自身或胎儿方面等原因,必须采用人工的方式来诱发子宫收缩而结束妊娠的一种行为。一般来说,女性在怀孕14~28周时,采用人工的方法来诱发子宫收缩而终止妊娠,可称为妊娠中期引产;怀孕28周后,采用人工的方法来诱发子宫收缩而终止妊娠,则称为妊娠晚期引产。引产过程中所进行的操作即为引产术。做引产手术并不存在具体的最佳时间,因为引产手术越早施行,对女性的伤害越小。因此,引产手术应尽量选择在怀孕12~24周内进行,在这期间,胎盘已经形成,胎儿较大

labor  英 ['leɪbə(r)]   美 ['lebɚ] 

释    义    n. 劳动;工作;劳工;分娩 vi. 劳动;努力;苦干 vt. 详细分析;使厌烦

词    根    labor  

adj. labored 吃力的;费劲的;不自然的

laboring 劳动的

labouring 劳动的;费劲的 

n. labour 劳动力,人工;分娩

laborer 劳动者;工人 

labourer 劳动者;劳工 

laboring 劳动;操劳

labouring 劳动 

例    句    However, after years of labor in their chosen field, they begin to hate their jobs.  

然而,他们在选择的领域工作了几年后,便开始讨厌自己的工作。

 

induction   英 [ɪnˈdʌkʃn]   美 [ɪnˈdʌkʃn] 

释    义    n. [电磁] 感应;归纳法;入门培训,入职仪式,就职;诱导

词    根    induct  

adj. inductive [数] 归纳的;[电] 感应的;诱导的

induced 感应的;诱发型 

n. inductor 感应器;授职者;

inductance 电感;感应系数;自感应

inductee 应召入伍的士兵;就任者

vt. induce 诱导;引起;引诱;感应 

induct 引导;感应;使…就职;征召入伍

例    句    Every induction is a speculation.  所有归纳推理都是一种猜测。

请扫描右侧二维码,免费查看词汇专业知识背景