Meta Analysis Of Different Drug Intervention In The Treatment Of Retained Placenta

Objectives:Retained placenta is one of the diseases with high incidence rate for the puerpera.Once it occurs,if it is not treated in time,it may lead to complications such as postpartum hemorrhage,infection and so on.At present,the main treatment is curettage,but curettage can not guarantee absolute effectiveness,and some adverse reactions may occur.In recent years,the treatment of retained placenta through drug intervention has gradually begun to be implemented,and some results have been achieved.Therefore,this study analyzes and evaluates the treatment effects of different drugs on maternal retained placenta,so as to judge whether the drug intervention of retained placenta is effective and which drug has better effect.Methods:On the corresponding retrieval platform,through computer and manual retrieval of MEDLINE,Web of Science and CNKI databases,the retrieved documents were strictly screened according to the screening flow chart and inclusion and exclusion criteria by using endnotex9 software.The two researchers independently evaluated the literature quality of the included studies according to different research types,extracted the basic information and data in the included studies,and summarized the data.Use reviewmanager5 3.The software performs meta-analysis on the statistical data.The differences of intervention effect indexes of different drugs on placental residue were analyzed and compared,and RR and CI were used to describe them.Results:1.This study finally included 22 articles,all in English,with a total of 3926 patients.2.By comparing the incidence of artificial removal of placenta after using different drugs,the results of outcome index analysis showed that there was no difference between oxytocin group and placebo group（RR = 0.84,CI =（0.61,1.16）,P = 0.29）,and there was no difference between prostaglandin group and placebo group（RR = 0.98,CI =（0.70,1.39）,P = 0.93）,There was no difference between nitroglycerin group and placebo group（RR = 0.93,CI =（0.78,1.11）,P = 0.43）.There was no difference between oxytocin group and prostaglandin group（RR = 1.56,CI =（0.81,3.01）,P = 0.18）,there was difference between oxytocin group and ergometrine group（RR = 0.57,CI =（0.35,0.92）,P = 0.02）,and there was difference between oxytocin group and cabetoxin group（RR = 1.44,CI =（1.03,2.02）,P = 0.04）.3.By comparing the probability of complications after oxytocin and placebo,the analysis results showed that there was no significant difference in the proportion of patients with postpartum hemorrhage ≥ 500 ml between the two groups（or = 0.92,CI=（0.75,1.13）,P = 0.42）,and there was no difference in the proportion of patients with postpartum fever between the two groups（RR = 1.45,CI =（0.61,3.45）,P =0.40）Conclusions:Oxytocin,prostaglandin and nitroglycerin have no obvious advantages in the treatment of placental residue,but after summary estimation and clinical experience,we can consider that oxytocin plays a positive role in promoting the spontaneous excretion of placenta.After comparison,the effect of cabetoxin is better than oxytocin,and the effect of oxytocin is better than ergometrine.The use of drugs to intervene in placental residue will not increase the incidence of complications and adverse reactions.It is feasible to use drugs to intervene in placental residue,but in clinical work,it is necessary to comprehensively estimate various different situations to choose a treatment method that is most beneficial to pregnant women.