催产素协议对接受剖腹产分娩的患者的二次子宫激素使用的影响
Paul R Davis1, Hans P Sviggum1, Katherine W Arendt1
1Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.
概括
在剖腹产后修改了"三项规则"的催产素协议,增加了对二次子宫激活药物的需求,但与持续输液相比,减少了严重的血液损失.
科学领域:
- 产科和妇科 产科和妇科
- 药理学 药理学是指药理学的学科.
- 患者安全 患者安全
背景情况:
- 催产素对于在剖腹产后预防产后出血至关重要.
- 标准的自由流输注可能会导致低于最佳剂量.
- 协议驱动的疗法旨在实现更一致和更有效的催产素管理.
研究的目的:
- 为了比较二次子宫的使用,修改了"三项规则"的催产素协议和剖腹产后的持续自由流输液.
- 评估该协议对输血率和估计的输血损失的影响.
主要方法:
- 之前和之后的回顾性研究,比较了2,262个前协议 (自由流动的催产素) 和1,748个后协议 (修改的三者的催产素规则) 剖腹产分娩.
- 主要结局:二次子宫使用.
- 二次结局:输血,血红蛋白<8g/dL,估计的血液损失>1000毫升.
主要成果:
- 经过修改的"三项规则"协议组增加了接受二次子宫激动药物的几率 (OR,1.33;P = 0.02).
- 血输率在后协议组较低,但复合终点 (输血或Hb<8g/dL) 类似.
- 估计血液损失> 1000毫升的几率在后协议组显著降低 (OR,0.64;P = 0.001).
结论:
- 修改后的"三项规则"催产素协议增加了需要二次子宫激活药物的可能性.
- 这一协议有效地减少了剖腹产后严重估计的血液损失.
- 两组之间,输血和严重贫血的结果是可比的.
相关概念视频
01:57Meiosis II
Meiosis II is the second and final stage of meiosis. It relies on the haploid cells produced during meiosis I, each of which contain only 23 chromosomes—one from each homologous initial pair. Importantly, each chromosome in these cells is composed of two joined copies, and when these cells enter meiosis II, the goal is to separate such sister chromatids using the same microtubule-based network employed in other division processes. The result of meiosis II is two haploid cells, each containing...
01:07Teratogenicity
The ability of a drug to produce structural deformations and functional abnormalities in the developing embryo or the fetus is called teratogenicity, and the drug producing this effect is known as a teratogen. Teratogenic effects include stillbirth, miscarriage, intrauterine growth restriction, and neurocognitive delay. A teratogen may affect the embryo at different stages of development, which is important in determining the type and extent of the damage. During blastocyst formation, the early...
01:24In Vitro Fertilization
In vitro fertilization (IVF) is a form of assisted reproductive technology where an egg is fertilized with sperm in a controlled laboratory environment before transferring the resulting embryo into the uterus. This process is designed to help individuals and couples experiencing difficulties conceiving.
The IVF process begins with ovarian stimulation, during which reproductive endocrinologists prescribe hormonal medications to stimulate the ovaries to produce multiple eggs instead of the single...
The IVF process begins with ovarian stimulation, during which reproductive endocrinologists prescribe hormonal medications to stimulate the ovaries to produce multiple eggs instead of the single...