确定的,低值剖腹产和多学科团队管理改善胎儿在怀孕期间急性胰腺炎的结果
Wenhua He1, Zhi Zhang2, Wenhao Cai3
1Pancreatic Disease Centre, Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, China; Liverpool Pancreatitis Research Group, Liverpool University Hospitals NHS Foundation Trust and Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK.
多学科的方法和剖腹产 (剖腹产) 的较低门显著改善了急性胰腺炎复杂的怀孕中胎儿的结果. 这一策略降低了胎儿死亡率,同时改善了母亲的健康结果.
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
- 胃肠病学 胃肠病学
背景情况:
- 孕期急性胰腺炎 (APIP) 具有重大风险,导致孕产妇和胎儿死亡率增加.
- 有效的管理策略对于减轻这些不利结果至关重要.
研究的目的:
- 评估在严重急性胰腺炎 (SAP) 或预测的SAP中剖腹产 (C-section) 的较低门是否能改善APIP患者的孕产妇和胎儿的结果.
- 评估多学科团队管理与降低C-section门对APIP结果的影响.
主要方法:
- 一个前性数据库被用来识别APIP患者.
- 在实施多学科团队和降低剖腹产门之前 (2005-2014) 和之后 (2015-2019) 的胎儿和母亲健康结果进行了比较.
- 用逻辑回归分析了胎儿死亡的风险因素.
主要成果:
- 在干预后,剖腹产率从30.8%显著增加到60% (P=0.001).
- 胎儿死亡率显著下降,从30.8%降至6.7% (P=0.001).
- 孕产妇死亡率从6下降到0 (P=0.19),孕产妇SIRS和SAP被确定为胎儿死亡的独立风险因素.
结论:
- 多学科的合作和低值的剖腹产是有效的改善胎儿的结果的患者与APIP.
- 这种管理方法在APIP病例中对孕产妇和胎儿健康产生了积极的影响.
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