روش‌های درمانی مؤثر بر القاء و شروع زایمان: مروری سیستماتیک

نوع مقاله : مروری

نویسندگان

1 دانشجوی دکتری تخصصی بهداشت باروری، کمیته تحقیقات دانشجویی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

2 استاد، مرکز تحقیقات علوم رفتاری، انستیتوی سبک زندگی، دانشکده پرستاری، دانشگاه علوم پزشکی بقیه الله، تهران، ایران.

3 استادیار گروه مامایی و بهداشت باروری، مرکز تحقیقات مامایی و بهداشت باروری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

چکیده

مقدمه: شروع خودبه‌خودی لیبر و زایمان تحت تأثیر عوامل مختلفی می‌باشد. حال آنکه گاهی اوقات لیبر و زایمان در موعد مقرر خود شروع نمی‌شود. عدم شروع لیبر در موعد مقرر، با افزایش عوارض مادری و جنینی و هزینه‌­های ناشی از آن همراه خواهد بود. مطالعات متفاوتی در جهت بررسی روش­های درمانی مؤثر بر القاء و شروع زایمان انجام شده است. مطالعه حاضر با هدف مروری سیستماتیک بر مطالعات انجام شده در مورد روش­های درمانی مؤثر بر القاء و شروع زایمان در ایران انجام شد.
روش‌کار: در این مطالعه مروری سیستماتیک، تمام کارآزمایی­های بالینی ایرانی چاپ شده به زبان فارسی و انگلیسی، از پایگاه‌های اطلاعاتی Google scholar، Scopus، IranMedex، SID، Medlib،IRCT ،Magiran  و PubMed با کلمات کلیدی فارسی"القای زایمان، لیبر، درد لیبر، شروع لیبر، کارآزمایی بالینی و زایمان" و کلمات کلیدی انگلیسی Delivery، ‌initiation of labor، clinical trial، labor pain، labor و  labor induction در عنوان و چکیده جستجو شد. بر اساس معیار جداد، مقالات با نمره 3 و بالاتر وارد مطالعه شد و تجزیه و تحلیل مطالعات به صورت کیفی انجام گرفت.
یافته‌ها: 29 کارآزمایی بالینی دارای معیار ورود به مطالعه بودند که در نهایت 23 مقاله به بررسی تأثیر روش­های درمانی دارویی (شامل 17 داروی شیمیایی و 6 داروی گیاهی) و 6 درمان غیر دارویی در القاء و تحریک لیبر پرداخته بودند. نتایج نشان داد میزوپروستول دارای تأثیر بیشتری در القای درد لیبر می­باشد. همچنین از بین داروهای گیاهی اسپند، خاکشیر، بابونه، روغن کرچک و از بین روش­های غیر دارویی لامیناریا نیز دارای تأثیر مثبتی بر القای لیبر می‌باشند.
نتیجه‌گیری: انواع متعددی از روش­های درمانی دارویی و غیر دارویی در القاء و تحریک لیبر نقش دارند. نتایج نشان داد با توجه به تعداد بیشتر مطالعات و نتایج مثبت ذکر شده، میزوپروستول در القای لیبر دارای تأثیر بیشتری می­باشد. سایر روش­های مؤثر در القای لیبر شامل اسپند، خاکشیر، بابونه، روغن کرچک و لامیناریا می­باشد. اما در تأیید تأثیر این روش‌ها، با توجه به تعداد کم مطالعات مورد بررسی، انجام مطالعات بیشتر با متدلوژی قوی‌تر مورد نیاز است.

کلیدواژه‌ها

عنوان مقاله [English]

Effective interventions for the induction of labor: A systematic review

نویسندگان [English]

  • Vida Ghasemi 1
  • Farzaneh Rashidi Fakari 1
  • Abbas Ebadi 2
  • Giti Ozgoli 3
  • Nourossadat Kariman 3
  • Marzieh Saei Gharenaz 1
1 PhD Student of Reproductive Health, Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
2 Professor, Behavioral Sciences Research Center, Lifestyle Institute, School of Nursing, Baqiyatallah University of Medical Sciences, Tehran, Iran.
3 Assistant Professor, Department of Midwifery and Reproductive Health, Midwifery and Reproductive Health Research Center, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
چکیده [English]

Introduction: The spontaneous onset of labor and delivery are influenced by several factors. However, labor sometimes does not start on the due date. This would result in increased maternal and fetal complications and costs. Many studies have investigated the effective treatments for labor induction. The present study was performed to systematically review the studies examining the effective interventions to induce labor in Iran.
material: This systematic review was conducted on the clinical trials published in the Persian and English languages. The searching process was performed in several databases, including Google scholar, Scopus, IranMedex, SID, Medlib, Magiran, IRCT, and PubMed, using the following English keywords and their Persian equivalents: “Labor”, “Labor induction”, “Delivery”, “Initiation of labor”, “Clinical trial”, and “Labor pain”. The articles, which obtained the score of ≥ 3 based on Jadad criteria, were entered to the study. The data were analyzed through qualitative methods. 
Results: The searching process resulted in the inclusion of 29 clinical trials, 23 and 6 cases of which investigated pharmacological treatments (including 17 chemical drugs and 6 herbal drugs) and non-pharmacological treatments, respectively. According to the results of the reviewed articles, misoprostol was found to be a more effective treatment for the induction of labor than other methods. In addition, among the herbal remedies, Peganum harmala, Descurainia sophia, chamomile, and castor oil and among the non-pharmacological methods, Laminaria were reported to have a positive effect on labor induction.
Conclusion: There are many types of pharmacological and nonpharmacological treatments for the induction of labor. Misoprostol was reported to be more effective in labor induction in the majority of the retrieved articles, revealing positive results in this regard. Furthermore, the use of Peganum harmala, Descurainia sophia, chamomile, castor oil, and Laminaria were proposed as effective methods for the induction of labor. However, the confirmation of the efficacy of these methods requires the implementation of further studies with a stronger methodology.

کلیدواژه‌ها [English]

  • Induction
  • labor
  • Onset of labor
  • Labor pain
  • Complementary Medicine

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مجله زنان، مامایی و نازایی ایران
دوره 21، شماره 1
فروردین 1397
صفحه 90-104

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