Loading...
Please wait, while we are loading the content...
Diuretics for preventing pre-eclampsia
| Content Provider | Scilit |
|---|---|
| Author | Churchill, David Beevers, Gareth Dg Meher, Shireen Rhodes, Catharine |
| Copyright Year | 2007 |
| Description | Journal: Cochrane Database of Systematic Reviews |
| Abstract | Diuretics are used to reduce blood pressure and oedema in non‐pregnant individuals. Formerly, they were used in pregnancy with the aim of preventing or delaying the development of pre‐eclampsia. This practice became controversial when concerns were raised that diuretics may further reduce plasma volume in women with pre‐eclampsia, thereby increasing the risk of adverse effects on the mother and baby, particularly fetal growth. To assess the effects of diuretics on prevention of pre‐eclampsia and its complications. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (May 2010). Randomised trials evaluating the effects of diuretics for preventing pre‐eclampsia and its complications. Three review authors independently selected trials for inclusion and extracted data. We analysed and double checked data for accuracy. Five studies (1836 women) were included. All were of uncertain quality. The studies compared thiazide diuretics with either placebo or no intervention. There were no clear differences between the diuretic and control groups for any reported pregnancy outcomes including pre‐eclampsia (four trials, 1391 women; risk ratio (RR) 0.68, 95% confidence interval (CI) 0.45 to 1.03), perinatal death (five trials,1836 women; RR 0.72, 95% CI 0.40 to 1.27), and preterm birth (two trials, 465 women; RR 0.67, 95% CI 0.32 to 1.41). There were no small‐for‐gestational‐age babies in the one trial that reported this outcome, and there was insufficient evidence to demonstrate any clear differences between the two groups for birthweight (one trial, 20 women; mean difference 139 grams, 95% CI ‐484.40 to 762.40). Thiazide diuretics were associated with an increased risk of nausea and vomiting (two trials, 1217 women; RR 5.81, 95% CI 1.04 to 32.46), and women allocated diuretics were more likely to stop treatment due to side effects compared to those allocated placebo (two trials, 1217 women; RR 1.85, 95% CI 0.81 to 4.22). There is insufficient evidence to draw reliable conclusions about the effects of diuretics on prevention of pre‐eclampsia and its complications. However, from this review, no clear benefits have been found from the use of diuretics to prevent pre‐eclampsia. Taken together with the level of adverse effects found, the use of diuretics for the prevention of pre‐eclampsia and its complications cannot be recommended. 利尿劑預防子癲癇前症 利尿劑用來減少沒有懷孕病人的高血壓和水腫。之前，利尿劑用於懷孕的婦女以預防或是延緩子癲癇前症的發生。而這一作法變得具有爭議性，因為利尿劑可能會使子癲癇前症婦女的血漿容積減少，而增加對於婦女、胎兒尤其是胎兒生長不良影響的機會。 評估利尿劑對於預防子癲癇前症和其併發症的成效。 我們搜尋了Cochrance Pregnancy and Childbirth Group's Trial Register(April 2005)，Cochrance Central Register of Controlled Trails(The Cochrance Library 2005, Issue 2) 以及 EMBASE(2002至 April 2005)。 評估利尿劑對於預防子癲癇前症和其併發症成效的隨機試驗(Randomised trials) 三位作者獨立篩選各試驗以收集和摘錄數據。我們分析和再次確認數據以求正確性。 共包含了五個試驗(1836位婦女)。所有的試驗都無法歸列等級。這些文獻上是比較Thiazide和安慰劑或是不介入。在於利尿劑對於懷孕結果包括子癲癇前症(四個試驗，1391個婦女，RR 0.68, 95%CI 0.67 至 1.03)、周產其死亡(五個試驗，1836個婦女，RR 0.72, 95%CI 0.40 至 1.27)或是早產(兩個試驗，465個婦女，RR 0.67, 95%CI 0.32 至 1.41)和對照組比較並沒有很明確的差別。沒有ㄧ個試驗紀錄過輕體重嬰兒這一結果，而且並沒有足夠的證據去證明兩個族群中出生體重的差別。(一個試驗，20個婦女，平均差異體重139公克，RR 0.72, 95%CI484.40至762.40) Thiazide對於增加噁心嘔吐的機會有關(兩個試驗，1217個婦女，RR 5.81, 95%CI 1.04至32.46) 以及分配到利尿劑這一組比起對照組較會因為副作用而停止治療(兩個試驗，1217個婦女，RR 1.85, 95%CI 0.81至4.22)。 沒有足夠的證據來可信得顯示，利尿劑對於預防子癲癇前症和其引發併發症的成效。但是，根據這個分析，並沒有發現有明確的益處有關利尿劑對於預防子癲癇前症。整合被發現的副作用，並不被建議使用利尿劑來預防子癲癇前症以及其併發症。 本摘要由周產期醫學會(Taiwan Society of Perinatology)羅如君翻譯。 此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。 子癲癇前症是ㄧ嚴重的懷孕併發症，婦女發生率約10％。它的定義是發生的高血壓和蛋白尿。一開始，婦女可能並沒有症狀。它的特徵是胎盤血管的收縮，影響胎兒氧氣和養分的供給，導致胎兒生長緩慢甚至於早產。有些婦女會全身水腫但少數會出現陷阱。利尿劑可以排出水份和舒張血管進而降低血壓。因為這一效果，利尿劑被建議或許預防懷孕婦女得到子癲癇前症。根據這一個基礎，這一類的藥物被用在懷孕婦女身上；然而，這可能會影響正常懷孕時體液容積增加而增加子癲癇前症風險。 本文包括共包含了五個隨機對照試驗，1836位婦女，去尋求尿劑對於預防子癲癇前症的證據。所有的試驗包括利尿劑和安慰劑或是不介入。然而，只有四個試驗，，1391位婦女，紀錄子癲癇前症。對於結果並沒有明確的區別，除了這些藥物會引發噁心嘔吐。 Diurétiques dans la prévention de la pré-éclampsie Les diurétiques sont utilisés pour réduire la pression artérielle et l'œdème chez les personnes qui ne sont pas enceintes. Auparavant, ils étaient utilisés pendant la grossesse afin de prévenir ou de retarder le... |
| Related Links | http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004451.pub2/pdf |
| ISSN | 1469493X |
| e-ISSN | 14651858 |
| DOI | 10.1002/14651858.cd004451.pub2 |
| Journal | Cochrane Database of Systematic Reviews |
| Issue Number | 7 |
| Volume Number | 2010 |
| Language | English |
| Publisher | Wiley-Blackwell |
| Publisher Date | 2007-01-24 |
| Access Restriction | Open |
| Subject Keyword | Journal: Cochrane Database of Systematic Reviews Obstetrics and Gynecology |
| Content Type | Text |
| Resource Type | Article |
