初级,二级和三级干预措施,以减少早产儿的发病率和死亡率
Jay D Iams1, Roberto Romero, Jennifer F Culhane
1Department of Obstetrics and Gynecology, Ohio State University, Columbus, OH, USA. iams.1@osu.edu
Lancet (London, England)
|January 15, 2008
概括
预防早产需要从婴儿的第三级护理转向所有妇女的初级和二级干预. 新的策略是必不可少的,因为尽管目前的治疗方法,早产率仍在上升.
科学领域:
- 产科和妇科 产科和妇科
- 新生儿科学 新生儿科学
- 公共卫生 公共卫生
背景情况:
- 过早分娩的干预措施分为初级,二级或三级.
- 目前的努力主要集中在对早产婴儿的第三级干预措施上,包括专业护理和医疗治疗.
- 尽管采取了这些措施,过早分娩的发生率仍在不断增加.
研究的目的:
- 分析目前早产干预措施的现状.
- 突出现有的第三级护理方法的局限性.
- 倡导制定初级和二级预防策略.
主要方法:
- 关于早产干预的现有文献的审查.
- 干预措施分为初级,中级和三级的分类.
- 分析早产发病率和结果的趋势.
主要成果:
- 三级干预措施,如区域化护理,产前皮质类固醇,托科利蒂克和抗生素,改善了围产期的结果.
- 矛盾的是,早产的发生率正在增加.
- 目前的干预措施并没有有效地制早产率的上升.
结论:
- 转向初级和二级预防的模式转变对于减少早产至关重要.
- 成功管理其他复杂健康问题的策略,如宫癌,可以为新的方法提供信息.
- 预防与早产相关的疾病需要针对所有妇女的积极措施和早期风险识别.
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