在玻利维亚,LMIC的一个研讨会后,增加了对HDP的ACOG诊断指南的遵守
Lilian Toledo-Jaldin1, Litzi Lazo-Vega1, Laura Grau2
1Hospital Materno-Infantil, Caja Nacional de Salud, La Paz, Bolivia.
Pregnancy hypertension
|October 1, 2023
概括
在玻利维亚实施修订的美国妇产科医生学院 (ACOG) 对妊娠高血压疾病 (HDP) 的指导方针,改善了严重特征 (sPE) 和相关不良孕产妇结果的妊娠前的识别.
科学领域:
- 产科和妇科 产科和妇科
- 孕产妇健康 孕产妇健康
- 低收入和中等收入国家的公共卫生.
背景情况:
- 妊娠高血压疾病 (HDP) 是孕产妇死亡的主要原因,特别是在低收入和中等收入国家 (LMIC).
- 美国妇产科医生学院 (ACOG) 更新了诊断指南,以更好地识别高风险怀孕.
- 这些修订后的ACOG指南在LMIC环境中的采用和影响以前是未知的.
研究的目的:
- 评估修订的ACOG诊断指南对玻利维亚拉巴斯的HDP的利用和影响.
- 评估ACOG指南的实施是否改善了对不良结果高风险怀孕的识别.
主要方法:
- 在玻利维亚拉巴斯举行了一场研讨会,以教育医疗保健提供者关于ACOG HDP指导方针.
- 产前和分娩记录被追溯审查HDP诊断和工作坊前后的控制.
- 总共有1376个HDP病例和2851个控制点从三个主要交付地点进行了分析.
主要成果:
- 虽然妊娠高血压 (GH) 和阴频率相似,但根据玻利维亚和ACOG标准,没有严重特征的阴过度报告,而具有严重特征的阴过少报告.
- 研讨会后,增加了蛋白尿的测试,检测异常的实验室,并确定了HDP患者的严重高血压.
- 在被诊断患有PE或sPE的女性中,在研讨会后符合ACOGsPE标准的女性中,不良孕产妇结果更为频繁.
结论:
- 在研讨会之后,ACOG指南的实施增加了它们的使用率.
- 修订后的指导方针改善了对PE和sPE怀孕的识别,这些怀孕经历了不利的孕产妇结果.
- 继续依赖旧的形式,只承认HELLP综合征为sPE,导致sPE报告不足.
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