Meta-analysis Of The Treatment Of Intrahepatic Cholestasis Of Pregnancy With Low Molecular Weight Heparin

Objective:Systematically reviewing the clinical efficacy of Low Molecular Weight Heparin in the treatment of Intrahepatic Cholestasis of Pregnancy to providing evidence-based basis for clinical medication.Methods:Documents in the recent 10 years that were searched on the database such as China National Knowledge Infrastr ucture(CNKI)?Wanfang data?CQVIP?PubMed and so on were sifting and evaluated methodological quality by scrupulous inclusion and exclusion criteria.Then RevM an 5.3 software was performed to meta-analysis.Results:A total of 12 chinese literature were contained.The results of meta-analysis revealed that,the application of Low Molecular Weight Heparin bettered patients' pruritus symptoms effectively(decreas ing the pruritus score[MD=-0.67,95%CI=(-1.29,-0.05),P=0.04]?shortening time to relieving pruritus[MD=-1.49,95%CI=(-2.09,-0.88),P<0.00001])?extended the g estational age[MD=1.46,95%CI=(0.10,2.82),P=0.04]?raised neonatal birth weigh t[MD=237.68,95%CI=(7.72,467.64),P=0.04]?reduced blood biochemical indexes including alanine aminotrans(ALT)[MD=-49.69,95%CI=(-58.42,-40.95),P<0.00001]?aspartate transaminase(AST)[MD=-29.72,95%CI=(-36.66,-22.77),P<0.00001]?total biliary acid(TBA)[MD=-8.36,95%CI=(-11.24,-5.48),P<0.00001]?total bilirubin(T B)[MD=-3.86,95%CI=(-7.11,-0.61),P=0.02]?abated fetal umbilical blood flow indicators including S/D values[MD=-0.74,95%CI=(-1.07,-0.41),P<0.0001]?RI values(drag index)[MD=-0.18,95%CI=(-0.33,-0.02),P=0.03]?PI values(pulsatility i ndex)[MD=-0.24,95%CI=(-0.29,-0.20),P<0.00001]and it also decreased the rates of postpartum hemorrhage[OR=0.34,95%CI=(0.13,0.87),P=0.02]?amniotic fluid contamination[OR=0.23,95%CI=(0.14,0.37),P<0.00001]?asphyxia neonatorum[OR=0.30,95%CI=(0.20,0.46),P<0.00001]?premature birth[OR=0.34,95%CI=(0.13,0.89),P=0.03],but there was no statistical differences in postpartum hemorrhage[MD=0.55,95%CI=(-10.63,10.73),P=0.99]and the rate of cesarean section[OR=0.60,95%CI=(0.19,1.94),P=0.40].Conclusion:It can significantly alleviate the patient's condition and improve pregnancy outcomes when Low Molecular Weight Heparin is applied to the treatment of Intrahepatic Cholestasis of Pregnancy.