胎盘断裂和不良的围产期结局
C V Ananth1, G S Berkowitz, D A Savitz
1Department of Obstetrics, Gynecology and Reproductive Sciences, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, New Brunswick 08901-1977, USA. ananthcv@epi.umdnj.edu
JAMA
|November 30, 1999
概括
胎盘断裂显著增加死胎的风险,特别是在严重分离的情况下. 即使有轻微的断裂,早产也很常见,影响胎儿的生长.
科学领域:
- 产科和妇科 产科和妇科
- 围产儿医学 围产儿医学
- 生殖健康 生殖健康
背景情况:
- 胎盘断裂与不良的妊娠结果有关,如围产期死亡,胎儿大小减少和更短的妊娠时间.
- 胎盘分离程度对这些结果的具体影响仍然不清楚.
研究的目的:
- 评估胎盘断裂及其对死产,早产和胎儿生长限制的贡献及其程度.
- 量化与不同程度的胎盘分离相关的风险.
主要方法:
- 追溯队列研究,包括1986年至1996年的53371例怀孕.
- 分析了死产,早产和胎儿生长限制与断裂有关的风险和相对风险.
- 评估了胎盘分离程度对不良结果的影响.
主要成果:
- 胎盘断裂发生在1%的怀孕中,与死产 (aRR 8.9),早产 (aRR 3.9) 和胎儿生长限制 (aRR 2.0) 的风险增加有关.
- 严重的胎盘分离 (≥50%) 显著增加死产风险 (75%分离的aRR为31.5).
- 即使是轻微的胎盘分离 (25%) 也大大增加了早产风险 (aRR 5.5).
结论:
- 胎盘断裂严重影响死产,早产和胎儿生长限制.
- 严重的胎盘分离会大大增加死产的风险.
- 过早分娩是一种常见的并发症,即使胎盘分离不那么严重.
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