胎盘生长因子测试以评估怀疑患有妊娠前的妇女:多中心,实用性,分阶集群随机对照试验
Kate E Duhig1, Jenny Myers2, Paul T Seed1
1Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, UK.
Lancet (London, England)
|April 6, 2019
概括
这项研究发现,使用胎盘生长因子 (PlGF) 测试结果显著减少了怀疑妊娠前的诊断时间. 在现实临床环境中,这种方法也降低了母亲的不良结果.
科学领域:
- 产科和妇科
- 产妇和胎儿医学
- 临床诊断
背景情况:
- 之前的研究表明,血管新生因子对子宫前的诊断准确度很高.
- 对于这些诊断测试的实际有效性仍然存在不确定性.
- 该研究解决了在临床实践中评估胎盘生长因子 (PlGF) 的需要.
研究的目的:
- 确定胎盘生长因子 (PlGF) 度的知识,与管理算法相结合,可减少怀疑妊娠前的诊断时间.
- 评估这种方法是否会减少孕产妇或产周期的不良结果.
- 在现实临床环境中评估PLGF测试的有效性.
主要方法:
- 一个多中心,实用,分阶集群随机对照试验,涉及11个英国产妇单位.
- 包括怀孕20至36周之间怀疑患有妊娠前的18岁以上妇女.
- 随机分配产妇单位以隐藏的plgf检测或干预的plgf检测和临床管理算法进行常规护理.
主要成果:
- 预孕诊断的中位时间从隐藏测试的4. 1天显著减少到显露测试的1. 9天 (时间比0. 36, p=0. 027).
- 与隐藏试验组 (5%) 相比,暴露试验组的严重不良结果较低 (aOR 0.32, p=0. 043).
- 两组之间没有观察到围产期不良结果或怀孕时的不良结果.
结论:
- 胎盘生长因子 (PlGF) 测试结果的可用性大大缩短了临床确认前的时间.
- 实行PlGF测试导致母亲不良结果的发生率降低,这可能是由于加强了监测.
- 这项研究支持在临床实践中对怀疑患有妊娠前的妇女进行PlGF测试.
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