臨床婦人科産科74巻2号

2020年03月発行

今月の臨床 はじめての情報検索―知りたいことの探し方・最新データの活かし方

ガイドラインからどのように情報を読み取るか

ガイドラインの使い方 : 周産期分野（診療ガイドライン産科編）

著者： 板倉敦夫¹

所属機関： ¹順天堂大学産婦人科

ページ範囲：P.253 - P.258

文献概要

●本ガイドラインの目的は「現時点でコンセンサスが得られた適正な標準的産科診断・管理法を示すこと」である．

●情報を読み取るには，CQに対する推奨要約の根拠となる解説を読むことが必要である．

●さらに深く読み取るには，文献にある論文を読み，その背景も含めてエビデンスを評価することが必要である．

参考文献

1）Hannah ME, et al : Planned caesarean section versus planned vaginal birth for breech presentation at term : a randomized multicenter trial. Term Breech Trial Collaborative Group. Lancet 356 : 1375-1383, 2000

2）Meis PJ, et al : Prevention of recurrent preterm delivery by 17 alpha-hydroxyprogesterone caproate. N Engl J Med 348 : 2379-2385, 2003

3）Hofmeyr GJ, et al : Planned Caesarean section for term breech delivery. Cochrane Database Syst Rev （1） : CD000166, 2001

4）Hofmeyr GJ, et al : Planned caesarean section for term breech delivery. Cochrane Database Syst Rev （7） : CD000166, 2015

5）Grobman WA, et al : Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units（MFMU）Network : 17 alpha-hydroxyprogesterone caproate to prevent prematurity in nulliparas with cervical length less than 30mm. Am J Obstet Gynecol 207 : 390.e1-390.e8, 2012

6）Nelson DB, et al : 17-alpha Hydroxyprogesterone caproate did not reduce the rate of recurrent preterm birth in a prospective cohort study. Am J Obstet Gynecol 216 : 600.e1-600.e9, 2017

7）Ibrahim M, et al : Progesterone supplementation for prevention of preterm labor : a randomized controlled trial. East Fertil Soc J 15 : 39-41, 2009

8）Saghafi N, et al : Efficacy of 17alpha-hydroxyprogesterone caproate in prevention of preterm delivery. J Obstet Gynecol Res 37 : 1342-1345, 2011

9）Fernandez-Macias R, et al : A systematic review and meta-analysis of randomized controlled trials comparing 17-alpha-hydroxyprogesterone caproate versus placebo for the prevention of recurrent preterm birth. Int J Gynaecol Obstet 147 : 156-164, 2019

10）Yamashita M, et al : Incidence and risk factors for recurrent spontaneous preterm birth : A retrospective cohort study in Japan. J Obstet Gynaecol Res 41 : 1708-1714, 2015

11）Lazar P, et al : Multicentred controlled trial of cervical cerclage in women at moderate risk of preterm delivery. Br J Obstet Gynaecol 91 : 731-735, 1984

12）MRC/RCOG Working Party on Cervical Cerclage : Final report of the Medical Research Council/Royal College of Obstetricians and Gynaecologists multicentre randomised trial of cervical cerclage. Br J Obstet Gynaecol 100 : 516-523, 1993

13）Berghella V, et al : Cerclage for short cervix on ultrasonography in women with singleton gestations and previous preterm birth : a meta-analysis. Obstet Gynecol 117 : 663-671, 2011