怀孕期间非产科手术及其对母亲和胎儿后果的影响:系统性审查
Anna Haataja1, Hannu Kokki2, Outi Uimari1,3
1PEDEGO Research Unit, Medical Research Center Oulu, University of Oulu, Oulu, Finland.
概括
在怀孕期间进行非产科手术并不常见,但会增加死产和早产的风险. 腹腔镜和开放腹部手术是孕妇患者可行的选择.
科学领域:
- 产科和妇科 产科和妇科
- 手术科学 手术科学
- 围产儿医学 围产儿医学
背景情况:
- 非产科手术在孕妇中进行,因此需要更新有关其影响的数据.
- 评估母亲和胎儿的结果对于明智的临床决策至关重要.
研究的目的:
- 系统地审查和更新关于孕妇非产科手术的数据.
- 评估怀孕期间非产科手术对孕产妇和胎儿结局的影响.
主要方法:
- 在MEDLINE和Scopus (2000年1月至2022年11月) 上进行了系统的文献搜索.
- 包括60项研究,包括80205名接受手术的妇女和16655486名对照.
- 结果措施包括流产,死胎,早产,低出生体重,Apgar分数,以及母亲/婴儿发病率和死亡率.
主要成果:
- 非产科手术的患病率在0.23%至0.74%之间 (中位数为0.37%),尾切除术是最常见的.
- 手术发生在三个月 (32%的第一,43%的第二,25%的第三),有计划和紧急手术的比例相等.
- 接受手术的女性死亡出生 (OR 2.0) 和早产 (OR 2.1) 的几率显著增加,但流产,低的阿帕格分数,对于妊娠年龄来说很小,或先天异常的几率没有增加.
结论:
- 怀孕期间的非产科手术与死产和早产的风险增加有关.
- 流产率,低的阿巴格分数,对于妊娠年龄来说很小,以及先天异常的发生率并没有显著增加.
- 腹腔镜和开放式手术技术都适用于孕妇的腹部手术.
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