全球性尿液药物查,在进入劳动和分娩时得到快速确认
Lylach Haizler-Cohen1,2, Ana Collins1, Dana M Kaplan3
1Department of Obstetrics and Gynecology, Staten Island University Hospital, Northwell Health, Staten Island, New York.
American journal of perinatology
|June 27, 2023
概括
具有快速确认 (RC) 的通用尿液药物查 (UDS) 识别了更多面临新生儿阿片类药物戒断综合征 (NOWS) 风险的母亲. 这种方法通过快速确认积极结果来减少不必要的婴儿观察和负担.
科学领域:
- 新生儿戒断综合征 新生儿戒断综合征
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 临床化学 临床化学
背景情况:
- 新生儿阿片类药物戒断综合征 (NOWS) 是一个越来越令人担忧的问题.
- 准确及时识别有风险的婴儿至关重要.
- 目前的查方法可能会导致假阳性,增加患者负担.
研究的目的:
- 评估在婴儿出院前使用液态染色体质谱法 (LC-MS) 快速确认的普遍尿药查 (UDS) 的影响.
- 改进对NOWS风险的新生儿的检测.
- 为了减少与假阳性查结果相关的负担.
主要方法:
- 一项两阶段的回顾性研究,比较了在RC与LC-MS实施之前和之后的UDS.
- 在入院时从孕妇收集尿液样本.
- 积极的免疫检测结果在LC-MS中得到证实;如果确认了母亲的阿片类药物,就选了婴儿.
主要成果:
- 在第二阶段,88.6%的分娩有UDS结果,其中2.5%通过LC-MS确认呈阳性.
- 在积极的UDS结果中,84%是阿片类药物,其中37%是意想不到的.
- 在对阿片类药物阳性母亲实施LC-MS RC后,新生儿NOWS的观察率从100%降至48%.
结论:
- 与LC-MS RC相结合的通用UDS可以增强未预期的阿片类药物阳性母亲的识别.
- UDS结果的RC确保干预是基于确诊病例,减少不必要的新生儿观察.
- 这一策略可以优化资源配置,减少婴儿和医疗保健系统的负担.
相关概念视频
Urine Studies II: Urine Culture and Sensitivity Test
58
A urine culture and sensitivity test is a diagnostic procedure used to identify urinary tract bacterial infections and determine the most effective antibiotics for treatment. This test is generally preferred when a patient shows manifestations of a urinary tract infection, such as frequent or painful urination, cloudy or foul-smelling urine, or lower abdominal pain.Purpose of the TestThe primary goals of a urine culture and sensitivity test are to:Determine the specific bacteria causing the...
58
Urine Studies I: Urinalysis
43
Urinalysis is a widely used diagnostic test that analyzes urine's physical, chemical, and microscopic characteristics. Healthcare providers use it to detect and monitor various health conditions, including renal disease, urinary tract infections (UTIs), diabetes, and metabolic or systemic disorders.Components of UrinalysisUrinalysis consists of three primary components: physical, chemical, and microscopic examination. Each provides unique insights into the urine sample and, by extension, the...
43
Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care
16
A healthcare provider can diagnose a urinary tract infection (UTI) through several methods:Medical History and Symptoms: The provider will take a detailed medical history and ask about symptoms such as frequent urination, burning sensation during urination, and lower abdominal pain.Urinalysis: A clean-catch urine sample is collected in a sterile container and tested for the presence of bacteria, white blood cells (leukocytes), nitrites, blood, and protein. The presence of leukocytes and...
16
Imaging Studies II: Ultrasonography
29
IntroductionUltrasonography, or renal ultrasound, is a noninvasive medical imaging technique that uses high-frequency sound waves to visualize the kidneys, ureters, bladder, and surrounding tissues.Indications for Urinary System UltrasonographyUrinary system ultrasonography is indicated in various clinical scenarios, such as:Kidney Stones (Urolithiasis): To detect and monitor the size and presence of kidney or urinary tract stones.Hydronephrosis: To assess the dilation of the renal pelvis and...
29
Acute Kidney Injury IV: Diagnostic Studies and Prevention
40
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
40
Drug Concentrations: Measurements
412
Drug concentration is the quantity of a drug present in a biological sample. Measuring drug amounts in biological samples allows the clinician to understand how a drug is absorbed, distributed, metabolized, and excreted. Samples can be obtained through invasive or non-invasive methods. Invasive techniques involve surgical or parenteral interventions to gather blood, cerebrospinal fluid, or tissue biopsy. Conversely, non-invasive approaches provide samples like urine, feces, and saliva.
Plasma...
Plasma...
412


