妊娠前出血症の原発的,二次的,三次的予防

G Dekker¹, B Sibai

¹University of Adelaide, Lyell McEwin Hospital, North Western Adelaide Health Service, SA, Australia. gustaaf.dekker@adelaide.edu.au

Lancet (London, England)

|February 24, 2001

まとめ

産前出血症は,産科における主要な問題である. プライマリ予防はまだ可能ではないが,カルシウム補給は,食事による摂取量が少ない女性にとって有益であり,産前ケアはこの状態の管理に不可欠である.

科学分野:

産婦人科と産婦人科を担当しています.
妊産婦・胎児医学について
公衆衛生は公衆衛生である.

背景:

産前出血症は,特に発展途上国において,世界的な健康上の大きな課題です.
妊娠中絶前症の病因はほとんど不明であり,初等予防戦略を阻害しています.
リスク要因を特定し,管理することは,子宮前出血症の発生率を減らすための鍵です.

研究の目的:

妊娠前出血症に関する現在の理解と管理戦略を見直す.
アスピリンやカルシウム補給などの介入の有効性を評価する.
重度のアウトカムを予防する上で,産前ケアと高血圧管理の役割について議論する.

主な方法:

妊娠前出血症のリスク要因と予防に関する研究の文献レビュー.
アスピリンとカルシウム補給に関する臨床試験データの分析.
産前ケアと抗高血圧薬の選択に関する証拠の検討.

主要な成果:

アスピリンは,主に重症早期発症の高リスク患者における二次予防に用いる.
カルシウム補給は,食事中のカルシウム摂取量が少ない女性にとって有益であることが示されています.
適度な母性高血圧は胎児に利益をもたらす可能性があるが,重度の高血圧は治療が必要で,カルシウムチャネルブロッカーはしばしばヒドララジンよりも好ましい.

結論:

妊娠前出血症の有効なプライマリ予防は,原因が不明であるため,現在実現不可能です.
アスピリンによる二次予防は,特定の高リスクグループに限定されています.
カルシウム補給,堅実な産前ケア,重度の高血圧の適切な管理は,治療結果を改善するために不可欠です.

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