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全球变化和CSP预期管理的结果
Helena C Bartels1, Donal J Brennan2, Ilan E Timor-Tritsch3
1Dept of UCD Obstetrics and Gynaecology, School of Medicine, University College Dublin, National Maternity Hospital, Holles Street, Dublin 2, Ireland.
概括
在全世界范围内,剖腹产痕怀孕 (CSP) 正在增加. 没有胎儿心脏活动的CSP的预期管理为母亲提供了良好的结果,但需要指导标准化.
科学领域:
- 生殖医学 生殖医学
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 诊断性超声波 超声波 超声波 超声波
背景情况:
- 剖腹产痕怀孕 (CSP) 是一个日益增长的全球关注.
- 确立的超声波标准存在于CSP诊断,但缺乏最佳实践指导预期管理.
- 显著的孕产妇发病率,包括出血和子宫切除术,与期望的CSP与胎儿心脏活动的管理有关.
研究的目的:
- 审查目前剖腹产痕怀孕诊断和预期管理的情况.
- 强调在管理CSP方面需要标准化最佳实践,特别是在资源较少的环境中.
- 评估CSP的预期管理的安全性和有效性,重点关注缺乏胎儿心脏活动的病例.
主要方法:
- 对现有关于剖腹产痕怀孕诊断和管理的文献进行系统审查.
- 在预期管理病例中分析报告的孕产妇死亡率和活产率.
- 在各种全球环境中评估诊断标准和结果.
主要成果:
- 在没有胎儿心脏活动的情况下,预期选择的CSP的管理与母亲的良好结果有关.
- 在一些预期管理的CSP病例中报告了高活产率.
- 对于CSP的预期管理协议的应用,在全球范围内存在相当大的差异.
结论:
- 对于特定的剖腹产痕怀孕,特别是那些没有胎儿心脏活动的怀孕,预期的管理是一个可行的选择.
- 关于CSP类型和结果的标准化报告对于制定基于证据的管理准则至关重要.
- 需要进行进一步的研究,以解决缺乏关于CSP诊断和管理在低资源环境中的文献问题.
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