ISSN: 2474-9230
Authors: Shun Yan HSU#, Eileen LEE, Rachel Hiu Yan CHAN, Yan-Bo Zhang, Lixing LAO, Haiyong CHEN* and Wei MENG*
Background: Threatened abortion is a common complication during early pregnancy. Conventional managements for the miscarriage include bed rest, hormone therapy and muscle relaxants. Traditional Chinese medicine (TCM) is also the popular option for the women. Evidence to support the efficacy and safety of TCM in treating threatened abortion is still limited. Objective: The study aimed to evaluate the safety and effectiveness of Chinese medicine in the treatment of threatened abortion compared with the hormone therapy through a systematic review and meta-analysis. Methods: The randomized controlled trials (RCTs) were electronically retrieved in the database of China National Knowledge Infrastructure (CNKI), Wan Fang Database (Chinese Ministry of Science and Technology), VIP Data and PubMed between January 1 2008 and December 1 2018 with the pre-designed search strategy. The outcomes included the clinical effectiveness, the clotting time of vaginal bleeding, pain reduction in lower abdomen, and incidences of adverse events. The software RevMan 5.1 was employed for the meta-analysis. Results: Twenty-three studies were included in the systematic review and meta-analysis, which enrolled 2014 pregnant women (1006 in the treatment group and 1008 in the control). The meta-analysis of clinical effectiveness showed that TCM significantly decreased rate of miscarriage compared with the conventional therapy. In the subgroup analysis of miscarriage rate in women, oral administration of TCM was more effective than either the injected or oral administration of conventional medications. Further analysis showed that oral TCM was more effective than the injection of progesterone only or combined with hCG, even the oral progesterone. Conclusions: The study indicated that TCM was likely more effective than conventional therapy in treating threatened abortion with unclear adverse events. However, due to the low quality of included studies, larger scales of RCTs and more scientific evidence are needed to prove the efficacy and safety of TCM for threatened abortion.
Keywords: Threatened Abortion; Clinical Efficacy; Evidence-Based Medicine; Meta-Analysis; Traditional Chinese Medicine
