胚胎液栓塞和医疗诱导分娩:一个回顾性,基于人口的队列研究
Michael S Kramer1, Jocelyn Rouleau, Thomas F Baskett
1Department of Paediatrics and Department of Epidemiology and Biostatistics, McGill University Faculty of Medicine, Montreal, QC, Canada. michael.kramer@mcgill.ca
Lancet (London, England)
|October 24, 2006
概括
医疗诱导分娩似乎增加了胚胎液栓塞的风险,这是一个罕见但严重的并发症. 这一发现对于关于选择性劳动诱导的知情决策很重要.
科学领域:
- 产科和妇科 产科和妇科
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 流行病学 流行病学
背景情况:
- 胚胎液栓塞 (AFE) 是一种罕见的,严重的,往往致命的母亲分娩并发症,病因不明.
- 调查AFE的潜在风险因素对于改善母亲的结果至关重要.
研究的目的:
- 研究医疗诱导分娩与羊水栓塞风险之间的关联.
- 评估与AFE相关的其他因素,包括母亲的年龄和分娩并发症.
主要方法:
- 一项基于人口的队列研究,研究了1991年至2002年间加拿大300万例医院分娩.
- 与医学和手术诱导,产妇年龄和其他产科因素相关的AFE总和致命率的分析.
主要成果:
- 医疗诱导分娩与整体羊水栓塞的风险几乎增加了一倍 (调整后的几率比为1.8).
- 医疗诱导和AFE之间的关联在致命病例中更强烈 (粗略概率比3.5).
- 增加的AFE风险也与母亲的晚年,剖腹产/仪器分娩以及各种妊娠/分娩并发症有关.
结论:
- 医疗诱导分娩似乎是胚胎液栓塞的危险因素.
- 虽然绝对的过度风险很低,但对这种关联的认识对于关于选择性劳动诱导的临床决策很重要.
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